Palatal perforations secondary to inhaled cocaine abuse. Presentation of five cases

Sanchez, Pedro; Sebastián, José Vicente Bagán; Soriano, Yolanda Jiménez; Pérez, María Gracia Sarrión

doi:10.4317/jced.2.e105

Cited by 9 publications

(6 citation statements)

References 10 publications

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“…The role of surgery is limited in gaining bioptic material and tumor debulking for functional purposes [1,16]. In case of oronasal fistulas/defects, an obturator can be fabricated and inserted to relieve the problem of regurgitation of food and fluids into the nasal cavity, improving speech, food intake and quality of life [36–39]. …”

Section: Discussionmentioning

confidence: 99%

Extranodal nasal–type NK/T-cell lymphoma of the palate and paranasal sinuses

et al. 2012

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SummaryBackground:Extranodal nasal-type natural killer (NK)/T-cell lymphoma represents a rare entity, typically originating in the nasal cavity, palate or midfacial region. Signs and symptoms include non-specific rhinitis and/or sinusitis, nasal obstruction, epistaxis, facial swelling and development of deep necrotic ulceration in the midline of the palate, causing an oronasal defect. Differential diagnosis includes fungal infections, Wegener’s granulomatosis, tertiary syphilis, other non-Hodgkin’s lymphomas and malignant epithelial midline tumors.Case Report:We present a case of a 40-year-old man complaining of headache, facial pain, nasal congestion and fever. Examination revealed a large deep necrotic ulcer in the middle of the palate, presenting as an oronasal defect. Endoscopic rhinoscopy revealed crusts in the nasal cavities, moderate perforation of the nasal septum cartilage and contraction of the middle and inferior conchae. Computer tomography showed occupation of the maxillary sinuses, ethmoidal cells and sphenoidal sinus by a hyperdense soft tissue mass. Laboratory investigation revealed increased erythrocyte sedimentation rate. A wide excision of the lesion was performed. Histopathological and immunohistochemical evaluation established the diagnosis of extranodal nasal-type NK/T-cell lymphoma. The patient was treated with CHOP chemotherapy, involved-field radiotherapy and autologous bone marrow transplantation. A removable partial denture with obturator was fabricated and inserted to relieve problems caused by the oronasal defect.Conclusions:Extranodal nasal-type NK/T-cell lymphoma is a very aggressive, rapidly progressing malignant neoplasm with a poor prognosis, which can be improved by early diagnosis and combined treatment.

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Section: Discussionmentioning

confidence: 99%

Extranodal nasal–type NK/T-cell lymphoma of the palate and paranasal sinuses

et al. 2012

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“…Distal flaps may be an option particularly for large defects. Recent evidence suggests promising results are obtainable with the use of microsurgical forearm flaps [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…An increase in dental caries has been seen in heroin abusers [19]. This might be the result of their intense craving for sweets [22][23][24][25][26], or due to apparent xerostomia, anxiety regarding dental treatment [22], and poor oral hygiene.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic management of palatal perforation in heroin abuse patient

Charkawi¹,

Nasar²

2015

Dent Oral Craniofac Res

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Heroin induced palatal perforation is a very infrequent complication. The authors report in this study a patient who suffered palatal perforation as a result of long time of snorting Heroin. He presented complaining of liquid passage from the oral cavity into the nasal cavities and hypernasality during speech. An immediate transparent acrylic partial obturator was constructed and fitted. It was successful in sealing the defect. However after 4 months an enlargement in the perforation was evident due to failure to cease the habit from the patient. It required the fabrication of new palatal obturator to seal the enlarged perforation and enhance the speech. This report discusses the possible lines of treatment of such complication. The report pointed out the possible prosthetic options. It also, emphasizes the importance of a multidisciplinary approach in management of drug abuse patients and complications encountered in their treatment. The use of palatal obturators improves patient quality of life, avoiding socially embarrassing situations such as the passage of fluids and solids into the nasal passages and maxillary sinuses, or a nasal tone.

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“…The true incidence of cocaine-induced complications is unknown, probably greater than we actually record, since many patients do not show up to specialists and abusers often hide or deny their habit 4. Subsequently, interpreting recent data on cocaine-associated mortality is challenging 3…”

Section: Global Health Problem Analysismentioning

confidence: 91%

Snorting the clivus away: an extreme case of cocaine-induced midline destructive lesion

et al. 2016

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Cocaine is a drug with relevant socioeconomic and clinical implications, which is usually recreationally used for its stimulant effects. It is widely known that the habit of snorting cocaine is associated with a peculiar type of drug-induced chronic rhinitis, which leads to inflammation of the sinonasal mucosa, slowly progressing to a destruction of nasal, palatal and pharyngeal tissues. These characteristic lesions due to cocaine abuse are commonly called cocaine-induced midline destructive lesions (CIMDL). Diagnosis is not always straightforward, since various conditions, mainly vasculitis, might mimic this acquired condition. The extent of pharyngeal involvement varies, although often a prolonged abuse can trigger a progressive destruction of oral and nasal tissues, with development of infections and recurrent inflammation. Our article focuses on cocaine as a world health problem with important ear, nose and throat implications and discusses the difficulties in diagnosing and treating CIMDL, through a case report.

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Palatal perforations secondary to inhaled cocaine abuse. Presentation of five cases

Cited by 9 publications

References 10 publications

Extranodal nasal–type NK/T-cell lymphoma of the palate and paranasal sinuses

Extranodal nasal–type NK/T-cell lymphoma of the palate and paranasal sinuses

Prosthetic management of palatal perforation in heroin abuse patient

Snorting the clivus away: an extreme case of cocaine-induced midline destructive lesion

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