A case of bisphosphonate-related osteonecrosis of the jaw complicated with myonecrosis of the temporal muscle

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  • IWAYA Katsumi
    Dental and Oral Medical Center, Kurume University School of Medicine
  • KOGA Makoto
    Dental and Oral Medical Center, Kurume University School of Medicine
  • TAKESHITA Yuko
    Dental and Oral Medical Center, Kurume University School of Medicine
  • TODOROKI Keita
    Dental and Oral Medical Center, Kurume University School of Medicine
  • IWAMOTO Osamu
    Dental and Oral Medical Center, Kurume University School of Medicine
  • KUSUKAWA Jingo
    Dental and Oral Medical Center, Kurume University School of Medicine

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Other Title
  • 側頭筋壊死を併発したビスフォスフォネート関連顎骨壊死の1例
  • ソクトウキン エシ オ ヘイハツ シタ ビスフォスフォネート カンレン ガッコツ エシ ノ 1レイ

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Abstract

We experienced a case of bisphosphonate-related osteonecrosis of the jaw (BRONJ) complicated with myonecrosis of the temporal muscle in a 78-year-old woman, who presented with a swelling in the right temporal region. She had a medical history of polymyalgia rheumatica and osteoporosis, and had been taking prednisolone for polymyalgia rheumatica and bisphosphonate for preventing osteoporosis. A CT scan revealed multiple abscesses in the temporal and masticator spaces. She was admitted to our hospital for anti-inflammation therapy. Even after surgical drainage in the temporal region and oral cavity, necrosis of the temporal muscle spread. Finally, most of the temporal muscle fell out and the temporal bone was exposed. After anti-inflammation therapy and local irrigation, necrotomy and a marginal resection of the mandible against BRONJ was performed under general anesthesia. Now, 29 months after the surgery, exposed bone is observed in the posterior division of the marginal resection of the mandible, so we have been continuing with the follow-up examinations.

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