Denosumab and bisphosphonate associated bilateral osteonecrosis of the external auditory canal.

We present a case of non-surgically managed bilateral osteonecrosis of the external auditory canal with a history of long-term medical therapy for osteoporosis. A 79-year-old woman with severe osteoporosis and destructive osteoarthritis received >10 years of once weekly bisphosphonate therapy before switching to denosumab. Four months later, the patient presented with bilateral loss of hearing and right-sided otalgia.

The water penetration of different ventilation tubes.

The insertion of middle ear ventilation tubes remains one of the most common procedures for ENT surgeons. A common concern amongst patients undergoing such procedures is the effect on their ability to partake in swimming and other water sports. Currently there is little evidence comparing the penetration ability of different water solutions encountered by swimmers.

Embryonic rhabdomyosarcoma presenting as Gradenigo's syndrome.

The authors report a previously undocumented case of parapharyngeal rhabdomyosarcoma presenting as Gradenigo's syndrome and review the history and aetiology of Gradenigo's syndrome. With sensitive diagnostic acumen this rare cause of Gradenigo's like syndrome was identified and correct treatment initiated.