Parotid salivary fistula is a relatively common complication after parotidectomy. Salivary fistula or sialocele occurs if the resected edge of the remaining salivary gland leaks saliva and drains through the wound or collects beneath the flap (sialocele)
doing nothing, just waiting 2-3 weeks and the saliva production stops under pressure - and the sialocele disappears by itself..
I would agree with Dr. Lemperle, however when that has not worked, or if the sialocoele presents a greater risks to other aspects of the healing, such as potential infection or wound complications, I have had good success with the use of botulinum toxin chemodenervation of the gland to slow or halt the production of saliva from the gland. An alternative approach is to use oral glycopyrolate to suppress salivary production, but this has some possible undesireable side effects.
If there are no contraindications, atropine i.m. for a 3 - 5 days or longer combined with the pressure dressings. In some cases it helped.
We have tried using Probanthine orally in acquired salivary fistulae along with Tympanic Neurectomy +/- excison & closure of fistulae with good results. Advantage is that it available in oral form but limitation is that it is rarely available.
Our experience with post surgery sialocoeles is that most of these disappear with conservative measures including pressure bandage and antisecretory anticholinergic drugs.
Botulinum Toxin is a viable option in refractory ones and where cost is the limiting factor one may consider tympanic neurectomy.