Abstract
Introduction and objective: Benign osteonecrosis of the external auditory canal (EAC) is a side effect pretty unknown due to bisphosphonate (BPs) therapy. Our aim is to describe the way of presentation and treatment of cases published in literature. Method: We did a systematic review of patients with diagnose of osteonecrosis of the external ear canal secondary to bisphosphonates from September 2003 till February 2019. We followed PRISMA criteria and evaluated PubMed database. Results: 7 articles were identified including a total of 17 patients with osteonecrosis of EAC. 76% were women and 24% men, within ages between 51 and 89. The duration time till complications appeared ranged from 15 months to 20 years. The most common presentation was as a unilateral ulceration with bone exposure in 41% of cases. Floor of the EAC was the initial place in 100%. Computed Tomography was performed in 47% of patients showing bone necrosis; and two biopsies with osteomyelitis signs. 9 patients (53%) were successfully treated with antibiotics and topical corticosteroids, while 8 cases (47%) needed surgical treatment in addition to the withdrawal of BFS. Discussion/Conclusions: Osteonecrosis of EAC is a rare side effect of BPs treatment. Painless ulceration on the EAC floor is the most common onset. Topical antibiotics and local debridement are frequently enough for complete healing.
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