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Case Reports: Reminder of important clinical lesson
Repair of a postaural fistula with a suprafascial radial forearm free flap
  1. Adam T Misky1,
  2. Allan Ponniah1 and
  3. Dariush Nikkhah1,2
  1. 1Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, London, UK
  2. 2University College London, London, UK
  1. Correspondence to Mr Dariush Nikkhah; d.nikkhah{at}nhs.net

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.

  • Radiotherapy
  • Radiology
  • Head and neck surgery
  • Otolaryngology / ENT
  • Plastic and reconstructive surgery

https://doi.org/10.1136/bcr-2021-244860

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    Footnotes

    • Twitter @atmisky

    • Contributors ATM, AP and DN contributed equally to the identification and conceptualisation of the case report. ATM collected images and data, wrote the article and obtained informed consent and patient’s perspective. DN and AP reviewed the manuscript and contributed to its final edition.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.