{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:58:07Z","timestamp":1792515487071,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cocaine is a recreational drug known for its negative impact on health and social and economic life. One of the complications for cocaine abusers is cocaine-induced midline destructive lesion (CIMDL) syndrome, which includes the extensive destruction of the osteocartilaginous structures of the nose, the sinus, and the palate. Methods: Here, we describe three cases of the surgical management of CIMDL using a temporalis muscle flap combined with a Le Fort I osteotomy, which allows sufficient space for the muscle to settle. Results: The addition of the osteotomy allowed better handling of the pedicled flap, with no signs of relapse in the reported cases and high patient satisfaction. Conclusions: CIMDL syndrome is an impairing disease that negatively affects the functionality of the nasal and oral cavities, as well as the aesthetic. Surgical repair using a pedicled flap is a valid option in rehabilitated and sober patients with endothelial damage.<\/jats:p>","DOI":"10.3390\/jcm14062033","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T06:36:23Z","timestamp":1742193383000},"page":"2033","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Surgical Management of Oro-Nasal Communication in Cocaine-Induced Lesions: Temporalis Muscle Flap with Le Fort I Osteotomy"],"prefix":"10.3390","volume":"14","author":[{"given":"Ettore","family":"Lupi","sequence":"first","affiliation":[{"name":"Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Ciccozzi","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Becelli","sequence":"additional","affiliation":[{"name":"Maxillofacial Unit, University \u201cLa Sapienza\u201d, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mannino","sequence":"additional","affiliation":[{"name":"Maxillofacial Unit, University \u201cLa Sapienza\u201d, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6130-8533","authenticated-orcid":false,"given":"Sara","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Giovannetti","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1001\/archotol.1989.01860250065028","article-title":"Nasal symptoms associated with cocaine abuse during adolescence","volume":"115","author":"Schwartz","year":"1989","journal-title":"Arch. 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