Acharya, Shreedhar PrasadPathak, ChetanaGiri, SandarvaBista, MeeraMandal, Deependra2026-08-122026-08-122020https://hdl.handle.net/20.500.14572/7236Shreedhar Prasad Acharya Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal Chetana Pathak Department of Ear, Nose and Throat, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal Sandarva Giri Department of Ear, Nose and Throat, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal Meera Bista Department of Ear, Nose and Throat, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal Deependra Mandal Kathmandu Medical College and Teaching Hospital, Kathmandu, NepalAbstract Though squamous cell carcinoma is the commonest tumor, it rarely presents in the middle ear and follows a history of chronic ear discharge. Postauricular mastoid fistula is also a rare complication of chronic otitis media. These two pathological changes occurring simultaneously are even rarer. We report a rare case of a 37 years old male with a history of left-sided chronic ear discharge and conductive hearing loss. Squamous cell carcinoma along with postauricular mastoid fistula was diagnosed based on high-resolution computed tomography scan and histopathology. Left modified radical mastoidectomy with tympanic membrane grafting was done under general anesthesia. Often middle ear tumor is associated with long-standing ear discharge and this case is a very good example. The co-occurrence of the middle ear tumor with mastoid fistula is extremely rare as both the entities are rare in itself. Keywords: fistula, mastoid, middle ear, squamous cell carcinomaen-USfistulamastoidmiddle earsquamous cell carcinomaArticle