{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:30:53Z","timestamp":1753882253448,"version":"3.41.2"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":170,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Otolaryngology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Cocaine is the second most consumed drug worldwide, more than 0.4% of the global population, and has become a real public health problem in recent years. Its inhalation causes significant centrofacial lesions, grouped under the name cocaine\u2010induced midline destructive lesion (CIMDL). These destructions are due to the conjunction of the vasoconstrictor, local prothrombogenic effects, and cytotoxic effects of cocaine. The ischemia produced by this substance is due to vasoconstriction that leads to nasal tissue necrosis and perforation of the nasal septum secondary to chondral necrosis. <jats:italic>Case Presentation<\/jats:italic>. A 36\u2010year\u2010old man, previously grappling with cocaine addiction, was hospitalized to undergo comprehensive clinical, microbiological, and radiological examinations because he was suffering from the emergence of crusts and ulceration in the nasal mucosa, accompanied by a palate perforation, a 39\u00b0C fever, and chills. Standard bacteriological culture was positive for coagulase\u2010negative staphylococci and <jats:italic>Escherichia coli<\/jats:italic>, while mycological culture was positive for <jats:italic>Candida tropicalis<\/jats:italic>. The CT scan images of the sinuses confirmed the presence of palatal perforation and total destruction of the nasal septum, cartilaginous portion, maxillary sinus medial wall, lower and middle turbinates, and middle meatus. Nasal endoscopy revealed an exposition of the bony wall and displayed the exposition of the occipital bone\u2019s clivus. A diagnosis of CIMDL was confirmed. Antibiotic therapy was decided based on antibiogram results by the consulting microbiologist. Debridement of necrotic tissue was done by nasal endoscopy with local cleaning and was repetitive during the first week to maintain the best cleanliness possible. The patient was discharged with oro\u2010nasal hygiene instructions and referred for prosthetic rehabilation. As for the cocaine addiction, the patient was in follow\u2010up with a psychologist in a specialized centre. <jats:italic>Conclusion<\/jats:italic>. The care is multidisciplinary. Psychological help and assistance are essential to guide patients to become cocaine free and to avoid a relapse. Weaning is a prerequisite for surgery. Rehabilitation of speech and swallowing is necessary. Many local flaps or micro\u2010anastomoses are possible.<\/jats:p>","DOI":"10.1155\/2024\/7109261","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T12:34:13Z","timestamp":1718800453000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral Rehabilitation for a Patient with Cocaine\u2010Induced Midline Destructive Lesions"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7658-1361","authenticated-orcid":false,"given":"Antoine","family":"Berberi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elie","family":"Azar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"e_1_2_8_1_2","doi-asserted-by":"crossref","DOI":"10.18356\/9789213626788","volume-title":"Global Report on Cocaine 2023-Local Dynamics, Global Challenges","author":"United Nations Office on Drugs and Crime","year":"2023"},{"volume-title":"European Drug Report 2022: Trends and Developments","year":"2022","author":"European Monitoring Centre for Drugs and Drug Addiction","key":"e_1_2_8_2_2"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-216393"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2021.04.011"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198612043152327"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1989.01860260109024"},{"key":"e_1_2_8_7_2","first-page":"351","article-title":"Severe avascular necrosis of the nasal chambers secondary to cocaine abuse","volume":"28","author":"Braverman I.","year":"1999","journal-title":"Journal of Otolaryngology"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1258\/0022215001906345"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200111000-00005"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1067\/moe.2002.121989"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/014556130208100313"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/194589240301700107"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4812171"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2013.04.034"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.revmed.2020.04.010"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/194589240401800405"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-022-07290-1"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.940569"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/194589240602000207"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.14639\/0392-100X-1586"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex001"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.08.010"},{"key":"e_1_2_8_23_2","first-page":"581","article-title":"Cocaina, ANCA e granulomatosi di Wegener [Cocaine, ANCA, and Wegener\u2019s granulomatosis]","volume":"93","author":"Morassi M. 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