A conchal island flap for postmastoidectomy retroauricular cutaneous fistula repair

Postmastoidectomy retroauricular cutaneous fistula is apparently a rare entity because its treatment is rarely discussed in the literature. We describe a reliable and satisfactory method of fistula repair that makes use of a turnover perichondriocartilaginous flap based posteriorly at the cavum concha. There are 2 advantages to the reflection of the posterior cartilaginous canal wall and part of the cavum concha. First, the widened external auditory meatus improves cavity aeration and drainage while preventing desquamation debris accumulation. Second, the resultant primary layered closure of the fistula is tension free. This flap had been successfully used in 5 patients who underwent modified radical mastoidectomy with partial preservation of the posterior bony wall. None of the patients needed a secondary revision, and none of them suffered aggravation of the disease.