Denosumab and bisphosphonate associated bilateral osteonecrosis of the external auditory canal

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Název: Denosumab and bisphosphonate associated bilateral osteonecrosis of the external auditory canal
Autoři: Harry David True, Rupert George Ricks, Joel Anthony Smith
Zdroj: Drug and Therapeutics Bulletin. 61:61-63
Informace o vydavateli: BMJ, 2021.
Rok vydání: 2021
Témata: calcium and bone, Bone Density Conservation Agents, Diphosphonates, ear, Ear Canal/diagnostic imaging, nose and throat/otolaryngology, 3. Good health, otolaryngology / ENT, Bisphosphonate-Associated Osteonecrosis of the Jaw/diagnostic imaging/surgery, otitis, Humans, Bisphosphonate-Associated Osteonecrosis of the Jaw, Female, unwanted effects / adverse reactions, Denosumab, Denosumab/adverse effects, Cholesteatoma, Ear Canal, Aged
Popis: We present a case of non-surgically managed bilateral osteonecrosis of the external auditory canal with a history of long-term medical therapy for osteoporosis. A 79-year-old woman with severe osteoporosis and destructive osteoarthritis received >10 years of once weekly bisphosphonate therapy before switching to denosumab. Four months later, the patient presented with bilateral loss of hearing and right-sided otalgia. Necrotising otitis externa, cholesteatoma and malignancy were considered but with histology, microbiological and CT assessment, bilateral osteonecrosis of the external auditory canal was diagnosed. Surgical debridement with canalplasty was avoided due to our patient’s comorbidities. Treatment continued for 5 months with regular aural toilet, Terra-Cortril ointment and bismuth-iodine-paraffin paste packing. At 1-year follow-up, bilateral external auditory canals were completely re-epithelialised with no pain or affected hearing. We report the first case of bilateral osteonecrosis of the external auditory canal associated with denosumab and bisphosphonates with successful conservative management.
Druh dokumentu: Article
Jazyk: English
ISSN: 1755-5248
0012-6543
DOI: 10.1136/dtb.2022.241203rep
DOI: 10.1136/bcr-2020-241203
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/34130974
https://pubmed.ncbi.nlm.nih.gov/36008096
https://pubmed.ncbi.nlm.nih.gov/34130974/
https://casereports.bmj.com/content/14/6/e241203
https://europepmc.org/article/MED/34130974
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208004
https://casereports.bmj.com/content/bmjcr/14/6/e241203.full.pdf
Přístupové číslo: edsair.doi.dedup.....c6b77cf0ffb4fbfa6f5f37d683c9bfe0
Databáze: OpenAIRE
Popis
Abstrakt:We present a case of non-surgically managed bilateral osteonecrosis of the external auditory canal with a history of long-term medical therapy for osteoporosis. A 79-year-old woman with severe osteoporosis and destructive osteoarthritis received >10 years of once weekly bisphosphonate therapy before switching to denosumab. Four months later, the patient presented with bilateral loss of hearing and right-sided otalgia. Necrotising otitis externa, cholesteatoma and malignancy were considered but with histology, microbiological and CT assessment, bilateral osteonecrosis of the external auditory canal was diagnosed. Surgical debridement with canalplasty was avoided due to our patient’s comorbidities. Treatment continued for 5 months with regular aural toilet, Terra-Cortril ointment and bismuth-iodine-paraffin paste packing. At 1-year follow-up, bilateral external auditory canals were completely re-epithelialised with no pain or affected hearing. We report the first case of bilateral osteonecrosis of the external auditory canal associated with denosumab and bisphosphonates with successful conservative management.
ISSN:17555248
00126543
DOI:10.1136/dtb.2022.241203rep