title: Snorting the clivus away: an extreme case of cocaine-induced midline destructive lesion.
abstract: 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.
authors: Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
authors: Marco
authors: M
authors: Molteni
authors: Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
authors: Alberto Maria
authors: AM
authors: Saibene
authors: Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
authors: Ketty
authors: K
authors: Luciano
authors: Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
authors: Alberto
authors: A
authors: Maccari
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D009300:Nasal Septum / Q000000981:diagnostic imaging / Q000473:pathology*; D009336:Necrosis / Q000000981:diagnostic imaging / Q000209:etiology*; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D010159:Palate / Q000000981:diagnostic imaging / Q000473:pathology*; D013203:Staphylococcal Infections / Q000209:etiology; D014057:Tomography, X-Ray Computed