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DOI: 10.1055/s-0037-1603791
Care of the Cocaine User with Nasal Deformity
Publikationsverlauf
Publikationsdatum:
28. Juli 2017 (online)
![](https://www.thieme-connect.de/media/fps/201704/lookinside/thumbnails/10-1055-s-0037-1603791_160116oa-1.jpg)
Abstract
Cocaine is the most commonly used stimulant in the Western world, and its use is increasing not only in young people but also in people older than 40 years. Intranasal use is associated with several pathologies, ranging from crusting and blockage, to fibrosis and scarring, to destruction of the osteocartilaginous structures of the midface. As its use becomes more prevalent in society, the reconstructive surgeon can accordingly expect to be faced with an increasing number of patients with cocaine-related nasal deformity. However, the use of cocaine adds a significant layer of complexity to the perioperative and operative care that requires careful consideration by the whole health care team. We present a practical evidence-based guide to management of reconstruction of the cocaine nose, taking in all aspects of periprocedural care. Finally, we present a model for surgical approach based on best evidence and the experience of the senior author. A search was performed of the Medline, Embase, and Cochrane Collection database using both MeSH keywords and free text words, identifying key articles on the epidemiology, pathophysiology, and medical and psychiatric comorbidities of cocaine users. Both case series and case reports reporting cocaine-associated defects and their reconstruction were reviewed together with the senior authors (A.D.S., A.J.), and a series of recommendations synthesized based on these recommendations. The nasal deformities associated with cocaine use represent only the tip of the iceberg of underlying associated pathology. The surgeon who embarks upon reconstruction of the cocaine nose should be aware of possible coexisting medical and psychiatric comorbidities that may complicate both the patient's motivations for surgery and their fitness to undergo anesthesia. Ultimately, successful reconstructive outcomes are critically dependent on holistic perioperative care and the surgeon's ability to be flexible in their surgical approach.
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References
- 1 Degenhardt L, Chiu WT, Sampson N. , et al. Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO World Mental Health Surveys. PLoS Med 2008; 5 (07) e141
- 2 Gossop M, Griffiths P, Powis B, Strang J. Cocaine: patterns of use, route of administration, and severity of dependence. Br J Psychiatry 1994; 164 (05) 660-664
- 3 https://www.gov.uk/government/publications/drug-misuse-findings-from-the-2013-to-2014-csew/drug-misuse-findings-from-the-201314-crime-survey-for-england-and-wales . Accessed November 11, 2016
- 4 Thomas KV, Bijlsma L, Castiglioni S. , et al. Comparing illicit drug use in 19 European cities through sewage analysis. Sci Total Environ 2012; 432: 432-439
- 5 Johanson CE, Fischman MW. The pharmacology of cocaine related to its abuse. Pharmacol Rev 1989; 41 (01) 3-52
- 6 Evrard I, Legleye S, Cadet-Taïrou A. Composition, purity and perceived quality of street cocaine in France. Int J Drug Policy 2010; 21 (05) 399-406
- 7 Chang A, Osterloh J, Thomas J. Levamisole: a dangerous new cocaine adulterant. Clin Pharmacol Ther 2010; 88 (03) 408-411
- 8 Zhu NY, Legatt DF, Turner AR. Agranulocytosis after consumption of cocaine adulterated with levamisole. Ann Intern Med 2009; 150 (04) 287-289
- 9 Bradford M, Rosenberg B, Moreno J, Dumyati G. Bilateral necrosis of earlobes and cheeks: another complication of cocaine contaminated with levamisole. Ann Intern Med 2010; 152 (11) 758-759
- 10 Buchanan JA, Vogel JA, Eberhardt AM. Levamisole-induced occlusive necrotizing vasculitis of the ears after use of cocaine contaminated with levamisole. J Med Toxicol 2011; 7 (01) 83-84
- 11 Chung C, Tumeh PC, Birnbaum R. , et al. Characteristic purpura of the ears, vasculitis, and neutropenia—a potential public health epidemic associated with levamisole-adulterated cocaine. J Am Acad Dermatol 2011; 65 (04) 722-725
- 12 Ullrich K, Koval R, Koval E, Bapoje S, Hirsh JM. Five consecutive cases of a cutaneous vasculopathy in users of levamisole-adulterated cocaine. J Clin Rheumatol 2011; 17 (04) 193-196
- 13 Harper SJ, Jones NS. Cocaine: what role does it have in current ENT practice? A review of the current literature. J Laryngol Otol 2006; 120 (10) 808-811
- 14 Gordon AS, Moran DT, Jafek BW, Eller PM, Strahan RC. The effect of chronic cocaine abuse on human olfaction. Arch Otolaryngol Head Neck Surg 1990; 116 (12) 1415-1418
- 15 Trimarchi M, Miluzio A, Nicolai P, Morassi ML, Bussi M, Marchisio PC. Massive apoptosis erodes nasal mucosa of cocaine abusers. Am J Rhinol 2006; 20 (02) 160-164
- 16 Trimarchi M, Gregorini G, Facchetti F. , et al. Cocaine-induced midline destructive lesions: clinical, radiographic, histopathologic, and serologic features and their differentiation from Wegener granulomatosis. Medicine (Baltimore) 2001; 80 (06) 391-404
- 17 Businco LD, Lauriello M, Marsico C, Corbisiero A, Cipriani O, Tirelli GC. Psychological aspects and treatment of patients with nasal septal perforation due to cocaine inhalation. Acta Otorhinolaryngol Ital 2008; 28 (05) 247-251
- 18 Libby DM, Klein L, Altorki NK. Aspiration of the nasal septum: a new complication of cocaine abuse. Ann Intern Med 1992; 116 (07) 567-568
- 19 Peikert T, Finkielman JD, Hummel AM. , et al. Functional characterization of antineutrophil cytoplasmic antibodies in patients with cocaine-induced midline destructive lesions. Arthritis Rheum 2008; 58 (05) 1546-1551
- 20 McGrath MM, Isakova T, Rennke HG, Mottola AM, Laliberte KA, Niles JL. Contaminated cocaine and antineutrophil cytoplasmic antibody-associated disease. Clin J Am Soc Nephrol 2011; 6 (12) 2799-2805
- 21 Wiesner O, Russell KA, Lee AS. , et al. Antineutrophil cytoplasmic antibodies reacting with human neutrophil elastase as a diagnostic marker for cocaine-induced midline destructive lesions but not autoimmune vasculitis. Arthritis Rheum 2004; 50 (09) 2954-2965
- 22 Stankowski RV, Kloner RA, Rezkalla SH. Cardiovascular consequences of cocaine use. Trends Cardiovasc Med 2015; 25 (06) 517-526
- 23 Schwartz BG, Rezkalla S, Kloner RA. Cardiovascular effects of cocaine. Circulation 2010; 122 (24) 2558-2569
- 24 O'Leary ME, Hancox JC. Role of voltage-gated sodium, potassium and calcium channels in the development of cocaine-associated cardiac arrhythmias. Br J Clin Pharmacol 2010; 69 (05) 427-442
- 25 Ebersberger U, Sudarski S, Schoepf UJ. , et al. Atherosclerotic plaque burden in cocaine users with acute chest pain: analysis by coronary computed tomography angiography. Atherosclerosis 2013; 229 (02) 443-448
- 26 Ammar AT, Livak M, Witsil JC. Old drug new trick: levamisole-adulterated cocaine causing acute kidney injury. Am J Emerg Med 2015; 33 (02) 309.e3-309.e4
- 27 Carlson AQ, Tuot DS, Jen KY. , et al. Pauci-immune glomerulonephritis in individuals with disease associated with levamisole-adulterated cocaine: a series of 4 cases. Medicine (Baltimore) 2014; 93 (17) 290-297
- 28 Jatem E, Agraz I, Semidei ME, Ferrer B, Ramos R, Fort J. Acute renal failure induced by acute interstitial nephritis secondary to cocaine. Nefrologia 2013; 33 (04) 601-622
- 29 Macdonald S, Pakula B, Martin G. , et al. Health profiles of clients in substance abuse treatment: a comparison of clients dependent on alcohol or cocaine with those concurrently dependent. Subst Use Misuse 2014; 49 (14) 1899-1907
- 30 Spronk DB, van Wel JH, Ramaekers JG, Verkes RJ. Characterizing the cognitive effects of cocaine: a comprehensive review. Neurosci Biobehav Rev 2013; 37 (08) 1838-1859
- 31 Vergara-Moragues E, González-Saiz F, Lozano OM. , et al. Psychiatric comorbidity in cocaine users treated in therapeutic community: substance-induced versus independent disorders. Psychiatry Res 2012; 200 (2–3): 734-741
- 32 Kalivas PW, Pierce RC, Cornish J, Sorg BA. A role for sensitization in craving and relapse in cocaine addiction. J Psychopharmacol 1998; 12 (01) 49-53
- 33 Verstraete AG. Detection times of drugs of abuse in blood, urine, and oral fluid. Ther Drug Monit 2004; 26 (02) 200-205
- 34 Pragst F, Balikova MA. State of the art in hair analysis for detection of drug and alcohol abuse. Clin Chim Acta 2006; 370 (1–2): 17-49
- 35 Erol OO. The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 2000; 105 (06) 2229-2241 , discussion 2242–2243
- 36 Gurley JM, Pilgram T, Perlyn CA, Marsh JL. Long-term outcome of autogenous rib graft nasal reconstruction. Plast Reconstr Surg 2001; 108 (07) 1895-1905 , discussion 1906–1907
- 37 Daniel RK. Rhinoplasty and rib grafts: evolving a flexible operative technique. Plast Reconstr Surg 1994; 94 (05) 597-609 , discussion 610–611
- 38 Gunter JP, Clark CP, Friedman RM. Internal stabilization of autogenous rib cartilage grafts in rhinoplasty: a barrier to cartilage warping. Plast Reconstr Surg 1997; 100 (01) 161-169
- 39 Christophel JJ, Hilger PA. Osseocartilaginous rib graft rhinoplasty: a stable, predictable technique for major dorsal reconstruction. Arch Facial Plast Surg 2011; 13 (02) 78-83
- 40 Moon BJ, Lee HJ, Jang YJ. Outcomes following rhinoplasty using autologous costal cartilage. Arch Facial Plast Surg 2012; 14 (03) 175-180
- 41 Kridel RW, Ashoori F, Liu ES, Hart CG. Long-term use and follow-up of irradiated homologous costal cartilage grafts in the nose. Arch Facial Plast Surg 2009; 11 (06) 378-394
- 42 Johnsen J, Bratt BM, Michel-Barron O, Glennow C, Petruson B. Pure sesame oil vs isotonic sodium chloride solution as treatment for dry nasal mucosa. Arch Otolaryngol Head Neck Surg 2001; 127 (11) 1353-1356
- 43 Osma U, Cüreoğlu S, Akbulut N, Meriç F, Topçu I. The results of septal button insertion in the management of nasal septal perforation. J Laryngol Otol 1999; 113 (09) 823-824
- 44 Luff DA, Kam A, Bruce IA, Willatt DJ. Nasal septum buttons: symptom scores and satisfaction. J Laryngol Otol 2002; 116 (12) 1001-1004
- 45 Kim SW, Rhee CS. Nasal septal perforation repair: predictive factors and systematic review of the literature. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (01) 58-65
- 46 Pedroza F, Patrocinio LG, Arevalo O. A review of 25-year experience of nasal septal perforation repair. Arch Facial Plast Surg 2007; 9 (01) 12-18
- 47 Woolford TJ, Jones NS. Repair of nasal septal perforations using local mucosal flaps and a composite cartilage graft. J Laryngol Otol 2001; 115 (01) 22-25
- 48 McLaughlin EJ, Friedman O. Surgical repair of nasal septal perforations: an update. Curr Opin Otolaryngol Head Neck Surg 2016; 24 (01) 37-42
- 49 Friedman M, Ibrahim H, Ramakrishnan V. Inferior turbinate flap for repair of nasal septal perforation. Laryngoscope 2003; 113 (08) 1425-1428
- 50 Murrell GL, Karakla DW, Messa A. Free flap repair of septal perforation. Plast Reconstr Surg 1998; 102 (03) 818-821
- 51 Kridel RW, Foda H, Lunde KC. Septal perforation repair with acellular human dermal allograft. Arch Otolaryngol Head Neck Surg 1998; 124 (01) 73-78
- 52 Ambro BT, Zimmerman J, Rosenthal M, Pribitkin EA. Nasal septal perforation repair with porcine small intestinal submucosa. Arch Facial Plast Surg 2003; 5 (06) 528-529
- 53 Cho JJ, Taylor RC, Deutschmann MW, Chandarana SP, Marck PA. Polyethylene implants in nasal septal restoration. JAMA Facial Plast Surg 2013; 15 (04) 275-279
- 54 Daneshi A, Mohammadi S, Javadi M, Hassannia F. Repair of large nasal septal perforation with titanium membrane: report of 10 cases. Am J Otolaryngol 2010; 31 (05) 387-389