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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.<\/jats:p>","DOI":"10.1136\/bcr-2016-216393","type":"journal-article","created":{"date-parts":[[2016,10,21]],"date-time":"2016-10-21T01:39:57Z","timestamp":1477013997000},"page":"bcr2016216393","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Snorting the clivus away: an extreme case of cocaine-induced midline destructive lesion"],"prefix":"10.1136","volume":"2016","author":[{"given":"Marco","family":"Molteni","sequence":"first","affiliation":[{"name":"Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Maria","family":"Saibene","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketty","family":"Luciano","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Maccari","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,10,20]]},"reference":[{"key":"2025081107551394000_2016.oct20_1.bcr2016216393.1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4812171"},{"key":"2025081107551394000_2016.oct20_1.bcr2016216393.2","doi-asserted-by":"publisher","DOI":"10.1067\/moe.2002.121989"},{"key":"2025081107551394000_2016.oct20_1.bcr2016216393.3","unstructured":"European Monitoring Centre for Drugs and Drugs Adiction. http:\/\/www.emcdda.europa.eu\/ (accessed 20 Nov 2015)."},{"key":"2025081107551394000_2016.oct20_1.bcr2016216393.4","doi-asserted-by":"crossref","first-page":"e105","DOI":"10.4317\/jced.2.e105","article-title":"Palatal perforations secondary to inhaled cocaine abuse. 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