Does Oral Antihistamine Use Reduce the Risk of Salivary Fistula Following Superficial Parotidectomy? A Retrospective Study

Objective: This study aimed to evaluate the effect of postoperative oral antihistamine (clemastine) use on the incidence of salivary fistula and sialocele in patients undergoing superficial parotidectomy. Materials and Methods: A retrospective analysis was conducted on 202 patients who underwent superficial parotidectomy for benign parotid tumours at the Department of Otolaryngology—Head and Neck Surgery, Necmettin Erbakan University, between 2020 and 2024. All patients were prescribed clemastine-containing antihistamines postoperatively; however, they were divided into two groups based on their access to and use of the medication. The development of salivary fistula and sialocele was assessed clinically. Data were analysed using Fisher's exact test, and p < 0.05 was considered statistically significant. Results: Salivary fistula was observed in 5 of 164 patients (3.0%) in the antihistamine group and in 5 of 38 patients (13.2%) in the non-user group. This difference was statistically significant (p = 0.022). The incidence of sialocele was three (1.8%) in the antihistamine group and two (5.3%) in the non-user group, with no significant difference between the groups (p = 0.237). The most common side effects in patients receiving antihistamines were drowsiness (12.1%), accommodation disorders (9.1%) and other mild anticholinergic symptoms. Conclusion: Oral antihistamine use following superficial parotidectomy may significantly reduce the incidence of salivary fistula. Most adverse effects were mild and tolerable. These findings suggest a potential benefit of antihistamines in the prevention of postoperative complications. © 2025 John Wiley & Sons Ltd.