{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T13:17:27Z","timestamp":1776863847398,"version":"3.51.2"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T00:00:00Z","timestamp":1589932800000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215120000894_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Levamisole is an increasingly common cutting agent used with cocaine. Both cocaine and levamisole can have local and systemic effects on patients.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215120000894_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>A retrospective case series was conducted of patients with a cocaine-induced midline destructive lesion or levamisole-induced vasculitis, who presented to a Dundee hospital or the practice of a single surgeon in Paisley, from April 2016 to April 2019. A literature review on the topic was also carried out.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215120000894_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Nine patients from the two centres were identified. One patient appeared to have levamisole-induced vasculitis, with raised proteinase 3, perinuclear antineutrophil cytoplasmic antibodies positivity and arthralgia which improved on systemic steroids. The other eight patients had features of a cocaine-induced midline destructive lesion.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215120000894_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>As the use of cocaine increases, ENT surgeons will see more of the complications associated with it. This paper highlights some of the diagnostic issues and proposes a management strategy as a guide to this complex patient group. Often, multidisciplinary management is needed.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215120000894","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T09:31:54Z","timestamp":1589967114000},"page":"440-446","source":"Crossref","is-referenced-by-count":17,"title":["A case series and literature review on patients with rhinological complications secondary to the use of cocaine and levamisole"],"prefix":"10.1017","volume":"134","author":[{"given":"R J","family":"Green","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q","family":"Gardiner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Vinod","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Oparka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P D","family":"Ross","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,5,20]]},"reference":[{"key":"S0022215120000894_ref4","unstructured":"4 United Nations Office on Drugs and Crime. 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