Destructive midline facial lesions secondary to cocaine use in the otolaryngology office of the Diagnostic Otolaryngology Instituteotorhinolaryngological office of the Instituto de Diagnósticoand Surgery Institute of Rosario (Argentina), year 2023

Introduction: Cocaine use is associated with chronic inflammation of the sinonasal mucosa that can result in destruction of the nose, palate, and pharyngeal and paranasal tissues. To describe the destructive lesions of the facial midline secondary to cocaine consumption presented by patients attending the otorhinolaryngological office of the Diagnostic and Surgical Institute of the city of Rosario in the year 2023. Quantitative, descriptive, observational, cross-sectional and retrospective study, carried out at the Instituto de Diagnóstico y Cirugía. The study population consisted of all patients of legal age, regardless of sex, who presented destructive lesions of the facial midline secondary to cocaine use. Data collection was performed through medical records after informed consent of the patients. Variables were analyzed through absolute and relative percentage frequencies and summarized through central position measures and dispersion measures. Five patients with destructive lesions of the facial midline were analyzed, 100% of them were men with a mean age of 33.20 ± 16.07 years (min. 17; max. 55). Eighty percent presented necrotizing ulceration, accompanied by crusting (40%), hemorrhage (40%), edema and swelling of the turbinates (20%). Eighty percent (n=4) presented lesions in the quadrangular cartilage, 40% (n=2) in the head of the middle and inferior turbinates and the anterior portion of the vomer respectively. The frequent symptoms of the destructive lesions of the facial midline were nasal congestion, hypoesthesia and anesthesia of the area, serous mucorrhea and bloody mucorrhea in 100% of the cocaine users. Secondary complications were rhinitis due to S.aureus, osteitis and ostiomyelitis, intense and intermittent hemorrhage, saddle nose due to quadrangular cartilage lesion and wide nasolaryngeal communication. in the study it was observed that cocaine users during the third decade of life frequently develop destructive lesions of the facial midline, which produce symptoms such as nasal congestion, hypoesthesia and bloody mucorrhea. In the study, 80% had ulcers and scabs in multiple locations, including the quadrangular cartilage, turbinates and vomer. Complications included S. aureus rhinitis, osteitis, ostiomyelitis, saddle nose and nasal-oral communication