The Singapore swing

The use of a rotation pedicled flap, entitled the 'Singapore Swing', comprising temporalis fascia and mastoid periosteum, is presented as a new method of promoting healing in 'open' mastoid surgery for chronic ear discharge. Cadaver studies show that the main blood supply of the flap is derived from a branch of the postauricular artery which enters the pedicle near the mastoid tip. A review of the first 14 operations showed complete healing with dry ears and intact tympanic membranes in all instances, three cases requiring secondary grafting of residual perforations. We consider the results sufficiently encouraging to merit an extended trial of the technique.