In a previous article a method of repair of postauricular fistulas by means of a free fat graft was described.1 This method has been satisfactory, but it is applicable only to cases of fistulas complicating simple mastoidectomy, when the opening between the middle ear and the mastoid cavity is completely closed. Occasionally, however, a fistula occurs following a radical mastoidectomy (fig. A). Obviously the use of the fat graft is of no avail in this type of case, because the mastoid cavity and the middle ear are epithelialized and permanently ventilated through the external canal of the ear. The problem in handling this condition is complex because one must supply an epithelialized covering for the cavity, whereas in the repair of such complications following the simple type the endeavor is to fill in and cover the defect. There are several methods advocated for the repair of fistulas utilizing the surrounding