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Case Reports
. 2022 Apr 13;15(4):e244860.
doi: 10.1136/bcr-2021-244860.

Repair of a postaural fistula with a suprafascial radial forearm free flap

Adam T Misky  1 , Allan Ponniah  1 , Dariush Nikkhah  2   3
Affiliations
Case Reports

Repair of a postaural fistula with a suprafascial radial forearm free flap

Adam T Misky et al. BMJ Case Rep. .

Abstract

We describe the case of a patient with the rare complication of a chronic postaural fistula following repeated and extensive surgery and adjuvant radiotherapy to the head and neck for a pleomorphic adenoma of the parotid gland. This case demonstrates the importance and value of thorough preoperative planning for major head and neck reconstruction, particularly if the area for reconstruction has distorted anatomy due to prior treatment or damage. In complex free flap reconstruction, it is important to investigate the recipient site with the help of arteriography and give due consideration to the donor site and its postoperative management. We highlight the importance of multidisciplinary work for the care of these patients not only intraoperatively, but also in the preoperative planning stage, and perhaps most importantly in the postoperative care.

Keywords: Head and neck surgery; Otolaryngology / ENT; Plastic and reconstructive surgery; Radiology; Radiotherapy.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
3D angiogram showing poor right external carotid vessel quality compared with left external carotid (both highlighted in red circles).
Figure 2
Figure 2
Postaural fistula and preoperative markings.
Figure 3
Figure 3
Postauricular defect following excision of fistula and necrotic tissue.
Figure 4
Figure 4
Preoperative markings of RFFF.
Figure 5
Figure 5
RFFF with vascular pedicle before flap is disconnected from donor site.
Figure 6
Figure 6
Immediate postoperative appearance of the postauricular reconstruction.
Figure 7
Figure 7
Postauricular reconstruction 8 months postoperatively.
Figure 8
Figure 8
Donor site 8 months postoperatively.
See this image and copyright information in PMC

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