Wickham N, Crawford A, Carney A S, Goss A N
Department of Haematology, Adelaide Cancer Centre, Adelaide, South Australia, Australia.
J Laryngol Otol. 2013 Jul;127 Suppl 2:S51-3. doi: 10.1017/S002221511300100X. Epub 2013 May 15.
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.
Two case reports of temporal bone osteonecrosis are presented.
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.
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.
骨坏死是一种以暴露的坏死骨为特征的良性疾病，与双膦酸盐的使用有关。外耳道骨坏死罕见，仅有少数病例报道。
本文报告两例颞骨骨坏死病例。
一名64岁患有免疫球蛋白Gκ多发性骨髓瘤的男性，在开始使用氯膦酸盐6年后出现右侧外耳道溃疡。一名72岁因骨质疏松服用阿仑膦酸钠的女性，最初被诊断为右侧外耳道炎并接受治疗，随后发现右侧外耳道有潜在的暴露骨组织，计算机断层扫描证实颞骨破坏。
随着社区中口服和静脉注射双膦酸盐在骨质疏松等良性疾病以及乳腺癌和多发性骨髓瘤等恶性疾病中的使用增加，对于有颞骨病变的患者，应始终考虑双膦酸盐相关骨坏死的诊断，并了解相关用药史。
