{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:03:16Z","timestamp":1760151796690,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T00:00:00Z","timestamp":1650326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>We present a case of a 69-year-old male who presented with acute left facial nerve palsy, serous bloody otorrhea, otalgia, and exposed necrotic bone on the floor of his left ear canal. His medical history revealed a left canal wall-down (CWD) mastoidectomy thirty years ago. Subsequently, twenty years later, he received primary chemoradiotherapy for tonsil cancer on the same side. The patient\u2019s medical history, the typical clinical picture, and a comprehensive diagnostic workup, including imaging modalities and electrophysiology, finally led to a diagnosis of osteoradionecrosis of the temporal bone (ORNTB), with secondary facial nerve palsy. The facial nerve, unfortunately, did not recover and treatment remained conservative, as per the patient\u2019s preference. ORNTB is a rare, delayed complication after radiotherapy for head and neck cancer, which occurs after about 8 years and a minimum of 41.8 Gray of radiation to the affected area. Facial nerve palsy in ORNTB is rare, with only 2.9% of patients experiencing it, but, in our particular case, the patient had undergone an additional CWD mastoidectomy. The treatment options need to be personalized and aimed at symptom control. There should be awareness of the condition among ENT specialists, especially during head and neck cancer follow-ups, and in patients who have had mastoidectomy and radiotherapy affecting the ipsilateral temporal bone.<\/jats:p>","DOI":"10.3390\/diagnostics12051021","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T02:39:31Z","timestamp":1650335971000},"page":"1021","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Osteoradionecrosis of the Temporal Bone as a Rare Cause of Facial Nerve Palsy"],"prefix":"10.3390","volume":"12","author":[{"given":"Florian","family":"Schmidt","sequence":"first","affiliation":[{"name":"ENT Department, Portsmouth Hospitals University, Portsmouth PO6 3LY, UK"},{"name":"Klinik f\u00fcr HNO-Heilkunde, Evangelisches Krankenhaus D\u00fcsseldorf, 40217 D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katy","family":"Bradley","sequence":"additional","affiliation":[{"name":"Oncology Department, Portsmouth Hospitals University, Portsmouth PO6 3LY, UK"},{"name":"Oncology Department, Brighton and Sussex University Hospitals, Brighton BN2 5BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1245-6331","authenticated-orcid":false,"given":"Gerd Fabian","family":"Volk","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany"},{"name":"Facial-Nerve-Center Jena, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany"},{"name":"Center of Rare Diseases Jena, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1177\/028418512600600135","article-title":"Radiation Osteitis","volume":"6","author":"Ewing","year":"1926","journal-title":"Acta Radiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/0278-2391(83)90294-X","article-title":"Osteoradionecrosis: A new concept of its pathophysiology","volume":"41","author":"Marx","year":"1983","journal-title":"J. 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Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1177\/0194599814564536","article-title":"Treatment outcomes of temporal bone osteoradionecrosis","volume":"152","author":"Kammeijer","year":"2015","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1097\/MAO.0b013e3181d8d6e1","article-title":"Temporal bone osteoradionecrosis after surgery and radiotherapy for malignant parotid tumors","volume":"31","author":"Leonetti","year":"2010","journal-title":"Otol. 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