Sialocutaneous fistula to the external auditory canal repaired with superficial parotidectomy and temporoparietal flap

RATIONALE Gustatory otorrhea can lead to cutaneous changes, recurrent infection, and social disruption. We present a case of a late, evolving sialocutaneous fistula to the external auditory canal, managed surgically after failing conservative therapies. This case is unique by late evolution, whereby the symptoms presented with significance 27 years after her operation and 19 years after mild symptoms initially arose. PATIENT CONCERNS Gustatory, left-sided clear otorrhea with acutely increased volume over 8 months causing social disruption. DIAGNOSES Sialocutaneous fistula to the external auditory canal. INTERVENTIONS Superficial parotidectomy and temporoparietal flap for closure of fistula. OUTCOMES No postoperative complications and resolution of gustatory otorrhea at one-year follow-up. LESSONS This rare, but important, postoperative complication can present late with evolving symptoms, causing significant social disruption. It can be treated with conservative medical management and several surgical approaches.