A fistula in the wound from an operation on the mastoid is always a source of extreme annoyance to the patient and a great disappointment to the surgeon. Unsightly scars following certain types of operative procedures are unavoidable. Because the pathologic processes of the temporal bone are better understood than formerly, operative technic has been so improved that except in rare instances there is little need for the scar following a mastoid operation to be unsightly or for a fistula to be present. However, one should not hesitate to perform an adequate operation for fear of producing an unsightly scar. It is possible to perform an adequate operation and still not leave an unsightly scar.
In the early days of mastoidectomy postoperative fistulas developed because wounds purposely were packed in order to compel healing "from the bottom" to take place. Another reason often mentioned for this method of postoperative care
LILLIE HI, PASTORE PN. REPAIR OF POSTOPERATIVE MASTOID FISTULA: REPORT OF A METHOD. Arch Otolaryngol. 1941;34(4):687–695. doi:10.1001/archotol.1941.00660040743001
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