The most common cause of parotid fistula is trauma. Other causes include operative complications, infection, and malignancy. In the acute phase of ductal injury, primary reconstruction, if possible, is the treatment of choice. Acute parenchymal injury is treated by tight closure and expectancy. When diverting or flow-blocking measures fail to correct chronic ductal fistula, the treatment of choice for this situation as well as for chronic parenchymal fistula may be tympanic neurectomy, which can be done under local anesthesia, is associated with low morbidity, is relatively uncomplicated, and has given excellent results to date in our hands.