ENT - Head and Neck Surgery Department, Hywel Dda University Health Board, Carmarthen, Wales, UK.
J Laryngol Otol. 2022 Oct;136(10):1002-1004. doi: 10.1017/S0022215122000706. Epub 2022 Apr 6.
This paper reports a case series of three elderly patients who were regularly attending ENT clinic every four to six weeks for ear canal care to address chronic otitis externa. All three patients had been taking bisphosphonate alendronic acid for years, and it is suspected that this drug was partly to blame for the progression of their chronic ear conditions.
Some improvements were noted when the bisphosphonate was discontinued. The regular microsuctioning, and application of topical antibiotics with steroids, provided temporary relief of symptoms. The present pandemic shut down the routine clinic and the patients were not seen for four to five months. On latest review, it was a surprise to see that their ears seemed to have significantly improved, with healthy re-epithelialisation.
It is thus believed that excessive and repeated microsuctioning in bisphosphonate-induced osteonecrosis of that external ear canal can delay re-epithelialisation, and gradually prolonging the intervals between microsuctioning could help in overall resolution of the disease.
本文报道了三例老年患者的病例系列，他们定期每四周至六周前往耳鼻喉科诊所进行耳道护理，以解决慢性外耳炎。这三名患者均长期服用双膦酸盐阿仑膦酸钠，怀疑这种药物是导致其慢性耳部状况恶化的部分原因。
停用双膦酸盐后，病情出现了一些改善。定期进行微吸和局部应用含皮质类固醇的抗生素暂时缓解了症状。目前的大流行导致常规诊所关闭，这些患者已经有四到五个月没有就诊了。最新的复查结果令人惊讶，他们的耳朵似乎有了明显的改善，上皮重新健康生长。
因此，人们认为在外耳道的双膦酸盐诱导性骨坏死中过度和反复的微吸会延迟上皮再生，逐渐延长微吸的间隔时间有助于整体疾病的解决。
