Osteoradionecrosis of the temporal bone

A case with diffuse osteoradionecrosis of the temporal bone is described. The patient had received radiotherapy for temporal bone carcinoma. Neuralgic pain and profuse offensive otorrhea first appeared with development of ulceration of the external auditory canal and mastoid cavity two months following irradiation. One year later, extensive sequesteration over both the external auditory canal and mastoid process, and facial nerve paresis developed. Repeated biopsies failed to prove recurrence of the malignancy. The patient was successfully treated by the radical exploration of the mastoid with decompression of the facial nerve, followed by closure with the forehead skin flap. The incidence, pathology, clinical manifestations and therapy of osteoradionecrosis of the temporal bone were reviewed and discussed with an emphasis on alerting the physician of this condition. (author)