Tympanic neurectomy for parotid fistula.

Complete excision of the trophic secretomotor parasympathetic nerve supply of the parotid gland produces abolition of its salivary secretion and ends in atrophy of the gland units. We report 20 patients treated by tympanic neurectomy to relieve the distressing problem of parotid fistulas. The tympanic nerve was identified and excised at its appearance through the hypotympanic floor. In seven of our cases, we found an early division of the main nerve that crossed the promontory anteriorly-hence, the importance of excising the tympanic nerve as proximal as possible. All patients observed for more than two years had complete dryness and cure of their fistulas. We describe the basis of tympanic neurectomy and its results compared with other forms of treatment.