title: Bisphosphonate-induced osteonecrosis of the external ear canal: a retrospective study.
abstract: In 2003, osteonecrosis of the jaw was described as an intraoral complication of bisphosphonate therapy. More recently, cases of avascular necrosis of the hip were reported in patients with long-lasting bisphosphonate therapy. Thus, it was the aim of the present study to analyze cases of benign osteonecrosis of the external ear canal and to retrospectively identify a possible relationship to long-lasting bisphosphonate therapy. 13 patients with osteonecrosis of the external ear canal operated on between 2005 and 2009 were included. Patient histories were reviewed for possible previous or current bisphosphonate therapy. Three patients with osteonecrosis of the external ear canal and long-term bisphosphonate therapy could be identified. They had been treated either for breast cancer or multiple myeloma. Certainly, the jaw is an area of increased risk for developing osteonecrosis with its high mechanical stress and intraoral bacterial flora. However, osteonecrosis of the hips and the external ear canal in patients receiving long-term bisphosphonate therapy necessitate further investigation of a possible systemic, bisphosphonate-related phenomenon.
authors.affiliation: Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Froelich
authors.affiliation: Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Radeloff
authors.affiliation: Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Köhler
authors.affiliation: Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Mlynski
authors.affiliation: Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Müller
authors.affiliation: Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Hagen
authors.affiliation: Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany. kleinsasser_n@klinik.uni-wuerzburg.de.
authors.forename: N H
authors.initials: NH
authors.lastname: Kleinsasser
mesh_terms: D000284:Administration, Oral; D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D004424:Ear Canal / Q000187:drug effects / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates