Three cases of uncommon medication-associated osteonecrosis of temporal bone  

作　　者：Hunter VanDolah Jason R.Crossley H.Jeffrey Kim 

机构地区：[1]Georgetown University School of Medicine,Washington DC,USA [2]Department of Otolaryngology–Head and Neck Surgery,MedStar Georgetown University Hospital,Washington DC,USA

出　　处：《World Journal of Otorhinolaryngology-Head and Neck Surgery》2024年第3期237-240,共4页世界耳鼻咽喉头颈外科杂志（英文）

摘　　要：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.

关 键 词：BISPHOSPHONATES DENOSUMAB external auditory canal imatinib medication-related osteonecrosis OSTEONECROSIS temporal bone tyrosine-kinase Inhibitors 

分 类 号：R764[医药卫生—耳鼻咽喉科]