Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T12:56:01.277Z Has data issue: false hasContentIssue false
  • English
  • Français

Bisphosphonate-associated osteonecrosis of the external auditory canal

Published online by Cambridge University Press:  15 May 2013

N Wickham ,
A Crawford ,
A S Carney  and
A N Goss
N Wickham
Affiliation:
Department of Haematology, Adelaide Cancer Centre, Adelaide, South Australia, Australia Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
A Crawford
Affiliation:
Flinders ENT, Department of Surgery, Flinders University, Adelaide, South Australia, Australia
A S Carney
Affiliation:
Flinders ENT, Department of Surgery, Flinders University, Adelaide, South Australia, Australia
A N Goss*
Affiliation:
Oral and Maxillofacial Surgery Unit, University of Adelaide, Adelaide, South Australia, Australia
*
Address for correspondence: Professor Alastair N Goss, Oral and Maxillofacial Surgery Unit, University of Adelaide, SA, Australia5005 Fax: +61 8 8303 4402 E-mail: alastair.goss@adelaide.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Osteonecrosis is a benign condition characterised by necrotic exposed bone, and is associated with bisphosphonate use. Osteonecrosis of the external auditory canal is rare, with only a few reported cases.

Method:

Two case reports of temporal bone osteonecrosis are presented.

Results:

A 64-year-old man with a history of immunoglobulin G kappa multiple myeloma developed a right external auditory canal ulcer 6 years after commencement on clodronate. A 72-year-old woman taking alendronate for osteoporosis, initially diagnosed and treated for right-sided otitis externa, was found to have underlying exposed bone in the right external auditory canal, with a computed tomography scan confirming destruction of the temporal bone.

Conclusion:

With increasing use of both oral and intravenous bisphosphonates in the community for benign conditions such as osteoporosis and for malignant conditions such as breast cancer and multiple myeloma, the diagnosis of bisphosphonate-associated osteonecrosis should always be considered in patients with a temporal bone lesion, and a relevant drug history taken.

Keywords

Bone DiseasesBisphosphonatesOsteonecrosisJawEar CanalTemporal Bone
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Supplement S2 , July 2013 , pp. S51 - S53
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Polizzotto, MN, Cousins, V, Schwarer, AP. Bisphosphonate-associated osteonecrosis of the auditory canal. Brit J Haematol 2006;132:114–17CrossRefGoogle ScholarPubMed
2Froelich, K, Radeloff, A, Köhler, C, Mlynski, R, Müller, J, Hagen, R et al. Bisphosphonate-induced osteonecrosis of the external ear canal: a retrospective study. Eur Arch Otorhinolaryngol 2011;268:1219–25CrossRefGoogle ScholarPubMed
3Marx, RE. Pamidronate (Aredia) and Zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003;61:1115–17CrossRefGoogle ScholarPubMed
4Ruggiero, SL, Mehrotra, B, Rosenberg, TJ, Engroff, SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004;62:527–34CrossRefGoogle ScholarPubMed
5Mavrokokki, A, Cheng, A, Stein, B, Goss, A. The nature and frequency of bisphosphonate associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg 2007;65:415–23CrossRefGoogle ScholarPubMed
6Vudiniabola, S, Pirone, C, Williamson, J, Goss, AN. Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones. Int J Oral Maxillofac Surg 2000;29:435–8CrossRefGoogle ScholarPubMed
7Crépin, S, Laroche, ML, Sarry, B, Merle, L. Osteonecrosis of the jaw induced by clodronate, an alkylbiphosphonate: case report and literature review. Eur J Clin Pharmacol 2010;66:547–54CrossRefGoogle ScholarPubMed
8Woo, SB, Hellstein, JW, Kalmar, JR. Systematic review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med 2006;144:753–761CrossRefGoogle Scholar
9Barasch, A, Cunha-Cruz, J, Curro, FA, Hujoel, P, Sung, AH, Vena, D et al. Risk factors for osteonecrosis of the jaws: a case-control study from the CONDOR dental PBRN. J Dent Res 2011;90:399–401CrossRefGoogle ScholarPubMed
10Lin, JH, Russell, G, Gertz, B. Pharmacokinetics of alendronate: an overview. Int J Clin Pract Suppl 1999;101:18–26Google ScholarPubMed