Publication details

Denosumab-related osteonecrosis of the external auditory canal-benefit of the early surgical management

Authors

PEŘINA Vojtěch SALZMAN Richard TREGLEROVÁ Jana

Year of publication 2024
Type Article in Periodical
Magazine / Source ENT-EAR NOSE & THROAT JOURNAL
MU Faculty or unit

Faculty of Medicine

Citation
Web https://doi.org/10.1177/01455613211053389
Doi http://dx.doi.org/10.1177/01455613211053389
Keywords osteonecrosis; surgical treatment; denosomab; auditory canal; ear
Description Background: Antiresorptive drugs are widely used to reduce bone mineral loss in patients with osteoporosis and to prevent skeletal-related events in patients with metastatic cancers and multiple myeloma (MM). Both the bisphosphonates (BP) and denosumab typically used in this indication were shown to be effective and relatively safe. Obviously, this medication could have some adverse effects; one of them is osteonecrosis of the external auditory canal. Only sporadic cases of external auditory canal osteonecrosis have been published yet. Here, we provide a case of denosumab-related osteonecrosis of the external auditory canal successfully treated surgically in the early stage of the disease. Case report: A 68-year-old patient with breast cancer underwent comprehensive oncological treatment, including denosumab administration. She was diagnosed with osteonecroses in the jaw and ear canal. The necrotic bones in both regions were resected with primary wound closure. Both affected sites healed well with no signs of necrosis recurrence. Conclusions: Osteonecrosis of the external auditory canal is a rare but probably underdiagnosed complication of antiresorptive medication. It has a negative impact on patient quality of life if left untreated. Early surgical treatment appears to be effective. The authors highlight several similarities with medication-related osteonecrosis of the jaw. Therefore, an analogous disease staging and treatment rationale is suggested.

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