Severe otorhinolaryngological infection due to medication-related osteonecrosis of the jaw: two case reports （descending necrotizing mediastinitis and osteomyelitis of the central skull base）

Abstract

Medication-related osteonecrosis of the jaw （MRONJ） is a known severe complication of using bone-modifying agents. This report describes two cases of MRONJ-induced severe otorhinolaryngological infection. Case 1: MRONJ-induced neck abscess and descending necrotizing mediastinitis. Drainage was performed through the cervical and thoracoscopic approaches; subsequently, the patient recovered and was able to resume oral food intake. Case 2: MRONJ-induced skull base osteomyelitis and inflammation attenuated by long-term antibiotic use. Treatment strategies for MRONJ-induced severe otorhinolaryngological infections vary considerably depending on the areas affected; therefore, appropriate medical and dental consultation is critical for selecting the treatment most appropriate for individual patients and their general condition.