Treatment of recurrent intractable periauricular fistula using temporoparietal fascia.

The temporoparietal fascia has been used extensively for vascularized tissue coverage, augmentation, and facial contouring. The temporoparietal fascial graft provides thin, broad, pliable, easily neovascularized, adequate coverage, contour, and bulk, as well as a hidden donor site. A 19-year-old woman had periauricular fistulae since she was 2 years. Her condition was diagnosed as left preauricular fistula, and she has been operated on by otolaryngologists 8 times and by plastic surgeons 2 times. The temporoparietal fascia was tunneled through a postauricular pocket to fulfill the cavity under her left earlobe and preauricular area. Facial fistulae were resolved without wound dehiscence, graft exposure, and recurred infection. Local preoperative tenderness was minimal. The temporoparietal fascial graft offers the following advantages as a 1-stage procedure: ease of neovascularization, being in the same operative field, being soft and compliant to the pocket, having a minimal graft resorption, and having a minimal donor site discomfort and disfiguration.