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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
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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 

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