Mock Jeremy A, Patel Jena, Gadre Arun, Greene Scott
Otolaryngology/Head and Neck Surgery, Geisinger Medical Center, Danville, USA.
Otolaryngology, Geisinger Commonwealth School of Medicine, Danville, USA.
Cureus. 2022 Jul 29;14(7):e27436. doi: 10.7759/cureus.27436. eCollection 2022 Jul.
Bisphosphonate therapy is commonly used to treat patients suffering from osteoporosis due to its clinical effectiveness and its generally benign safety profile; however, osteonecrosis of the jaw is a rare side effect that can occur in some patients. A far less elucidated area of concern is the effect of these medications on osseointegrated implants, which require adequate bone formation to ensure long-term viability of the implant. To date, there are no reports in the otolaryngology literature examining the interplay between osteoporosis, bisphosphonate therapy, and osseointegrated bone-anchored hearing aids (BAHA). In this case report, we describe an osteoporotic patient on bisphosphonates experiencing late bilateral failure of her osseointegrated BAHA implants shortly after starting therapy. Certainly, direct causality cannot be determined from this single report, but the temporal relationship described in this case suggests a potential interaction between bisphosphonate use and delayed failure of the osseointegrated hearing devices. Consequently, otolaryngologists who implant osseointegrated hearing devices should consider offering preoperative counseling to patients receiving bisphosphonate therapy.
双膦酸盐疗法因其临床疗效和总体良好的安全性，常用于治疗骨质疏松症患者；然而，颌骨坏死是一种罕见的副作用，可能发生在一些患者身上。一个远未得到充分阐明的关注领域是这些药物对骨整合植入物的影响，骨整合植入物需要足够的骨形成以确保植入物的长期存活。迄今为止，耳鼻喉科文献中尚无关于骨质疏松症、双膦酸盐疗法和骨整合骨锚式助听器（BAHA）之间相互作用的报道。在本病例报告中，我们描述了一名接受双膦酸盐治疗的骨质疏松症患者，在开始治疗后不久，其双侧骨整合BAHA植入物出现晚期失败。当然，仅凭这一单一报告无法确定直接因果关系，但本病例中描述的时间关系表明双膦酸盐的使用与骨整合听力装置的延迟失败之间可能存在相互作用。因此，植入骨整合听力装置的耳鼻喉科医生应考虑为接受双膦酸盐治疗的患者提供术前咨询。
