McCadden L, Leonard C G, Primrose W J
ENT Departments,Royal Victoria Hospital,Belfast,and Craigavon Area Hospital,NorthernIreland,UK.
J Laryngol Otol. 2018 Apr;132(4):372-374. doi: 10.1017/S0022215118000324. Epub 2018 Feb 28.
Oesophageal disorders and osteonecrosis of the jaw are recognised complications of the commonly prescribed medication bisphosphonate. Despite these diagnoses being seen comparatively frequently within the ENT clinic, osteonecrosis of the external ear is a less well reported complication.
The current literature is reviewed and our experience with six cases of bisphosphonate-related ear canal osteonecrosis is presented.
Six cases were identified as suffering from ear canal osteonecrosis as a result of bisphosphonate treatment. One of our cases suffered bilateral ear canal osteonecrosis after only 20 months of oral alendronic acid treatment. Management ranged from bisphosphonate cessation and topical treatment, to surgical debridement in the operating theatre.
Bisphosphonate-related ear canal osteonecrosis is undoubtedly under-diagnosed. For such a commonly prescribed medication, the risks and side effects of bisphosphonate should be better known and long-term treatment should be avoided if possible.
食管疾病和颌骨坏死是常用药物双膦酸盐公认的并发症。尽管这些诊断在耳鼻喉科门诊相对常见，但外耳道骨坏死作为一种并发症报道较少。
回顾当前文献，并介绍我们诊治6例双膦酸盐相关外耳道骨坏死的经验。
6例被确诊为因双膦酸盐治疗导致外耳道骨坏死。我们的1例患者在口服阿仑膦酸仅20个月后就出现了双侧外耳道骨坏死。治疗方法包括停用双膦酸盐和局部治疗，以及在手术室进行手术清创。
双膦酸盐相关外耳道骨坏死无疑诊断不足。对于这种常用药物，双膦酸盐的风险和副作用应更广为人知，且应尽可能避免长期治疗。
