Postauricular Cutaneous Mastoid Fistula Surgically Closed by a Temporalis Muscle Rotational Flap: A Case Report

 Postauricular cutaneous mastoid fistula (PCMF) is quite rare. Possible triggers include a radical mastoidectomy, chronic suppurative otitis media (CSOM), or the spontaneous exteriorization of a mastoid cholesteatoma through the postauricular skin surface.

Case Report: 

This study reported a 62-year-old woman who presented with a right-sided discharging postauricular lesion for two years and a history of ear discharge over the past 20 years. Physical examination revealed a 10×8 mm fistula with a pearly white tissue at the opening and mucoid discharge. Otoscopy represented an attic cholesteatoma as the potential underlying cause, and computed tomography demonstrated a soft-tissue density in the middle ear extending into the mastoid cavity and towards the cutaneous postauricular area. The PCMF was surgically closed using a temporalis muscle rotational flap with no recurrence at the 6-month follow-up.

 Overall, surgical closure with a temporalis muscle rotational flap appears to be an effective technique for treating PCMF.