ArticleWorld journal of otorhinolaryngology - head and neck surgery2024
Three cases of uncommon medication-associated osteonecrosis of temporal bone.
Article in World journal of otorhinolaryngology - head and neck surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Bilateral osteonecrosis of the external auditory canal caused by bone-modifying agents for cancer bone metastases.International cancer conference journal · 2025Article
- Three cases of uncommon medication-associated osteonecrosis of temporal bone.World journal of otorhinolaryngology - head and neck surgery · 2024Article
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Abstract
Introduction: Medication-related osteonecrosis of the temporal bone is rare and has been reported to be associated with the use of anti-resorptive and biologic agents. Here, we present the first case of tyrosine-kinase inhibitor-related external auditory canal (EAC) osteonecrosis as well as two cases related to anti-resorptive therapies. Methods: A retrospective case series. Results: Case one: an 84-year-old female presented with chronic otitis externa and osteonecrosis of EACs bilaterally. She had a history of osteoporosis treated with denosumab and risedronic acid. She successfully underwent left EAC reconstruction using an inferiorly-based pedicle periosteal flap while the right ear canal was managed conservatively. Case two: a 69-year-old male presented with osteonecrosis of the right EAC. He had a history of osteoporosis treated with alendronic acid and zoledronic acid. His osteonecrosis is conservatively managed with local debridement and antibiotic application. Case three: a 60-year-old male presented with osteonecrosis of the right inferior EAC. He had a history of chronic myelogenous leukemia treated with a tyrosine-kinase inhibitor, imatinib. After failing conservative therapy, he underwent right ear canal reconstruction using a periosteal vascular pedicle flap without complication and experienced complete resolution to his symptoms. Conclusion: Anti-resorptive agents and/or tyrosine kinase inhibitors may lead to dysregulation of bone remodeling and result in rare cases of temporal bone osteonecrosis. When a local debridement and antibiotic therapy fail, definitive surgical excision of necrotic bone with subsequent reconstruction of the EAC may offer patients a possible resolution in symptoms.
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