Otosialorrhoea - Diagnostics and therapy of a salivary fistula of the external auditory canal

Patient: We report the case of a 49 year old femal patient who suffered from frequent secretion of the left external canal of the ear after the treatment of a chronic mycotic otitis externa. The secretion was seen in connection with food intake. An operative revision in another hospital remained without success. The diagnostics covered the biochemical verification of saliva-amylase in the secretion, but also a high resolution MRI of the parotid gland. By this diagnostics it was easy to locate the salivary fistula during the operation. Discussion: Salivary fistulas of the parotid gland to the external ear-canal are very rare. These fistulas develop after injury of the parenchyma or the gland ductus and also after surgery of the head- and neck-region. A otosialorrhoea rarely originates from a chronic inflammatory of the ear canal. These fistulas are assigned to the fissures of Santorini and the foramen of Huschke. The therapy of salivary fistulas to the external ear canal reaches from clossure of the fistula to total parotidectomy. But also a medicamental suppression of salivation, irradiation and a tympanic neurectomy are discussed in the literature.