Diffuse Osteoradionecrosis of Temporal Bone as a Late Complication of Adjuvant Radiotherapy to Parotid Bed: A Case Report

Abstract

Localized osteoradionecrosis of bony external auditory canal has been described as a late complication of external beam radiotherapy which is delivered to parotid bed after surgical resection of parotid malignancies. Diffuse osteoradionecrosis of temporal bone is rarely seen in such a setting and it is usually caused by resection of part of the bone for surgical clearance, followed by post-operative radiotherapy. This condition warrants aggressive treatment, in order to avoid potentially life threatening intracranial complications. In this report, we are presenting an uncommon case of extensive osteoradionecrosis which involved the entire temporal bone, in a patient who was treated for mucoepidermoid carcinoma of parotid twelve years ago, with total conservative parotidectomy and adjuvant radiotherapy. CASe RepoRTA 66-year-old lady, a known diabetic and hypertensive, presented to our head and neck Surgical Oncology Out-Patients Department with complaints of a painless mass in the right ear canal, present since the past 2 years, intermittent right ear discharge since the past 1 year and discharge from behind the ear since the past 3 months. The discharge was foul smelling and occasionally blood stained. She had been taking local treatment in the form of ear drops on and off for her symptoms, but the complaint persisted.