Novel Technique Closure of Mastoid Fistula with Three-Layer Pedicled Flap: A Case Report and Literature Review

Mastoid fistula is a rare condition, its causes include chronic suppurative otitis media and repeated ear surgeries. Management is challenging, simple closure typically leads to recurrence due to surrounding necrotic skin edges. Several surgical techniques have been described. In this paper, we present a case of a 60 year old lady who presented with chronic right ear discharge post radical mastoidectomy due to acquired cholesteatoma. At presentation, there was a mastoid opening found over her auricular sulcus, endoscopic examination showed a well epithelized mastoid cavity with mucopurulent discharge, CT of temporal bone correlated with physical findings. The fistula was surgically closed with a three-layer pedicled flap and the fistula was fully healed at the 1-month follow up.