Otolaryngology manifestations of cocaine abuse.

Abstract

BACKGROUND: Cocaine abuse is a common practice with acute and chronic consequences in the upper airway, clinical suspicion by professionals is essential to identify cases.

OBJECTIVE: To describe the otorhinolaryngological manifestations related to cocaine abuse.

MATERIALS AND METHODS: A retrospective, descriptive, observational study was done with the medical records of patients who consulted for head and neck problems related to cocaine abuse from January 2016 to March 2019. Bibliographic research was conducted in MEDLINE, between 1990 and 2018, using the word “cocaine” and the following search terms: head and neck, nasal, oral cavity, pharynx, nasopharynx, oropharynx, hypopharynx, larynx, trachea, paranasal sinus, sinusitis, otitis, ear, hearing loss and vertigo.

RESULTS: During the study period, six patients with otorhinolaryngological manifestations related to cocaine abuse were treated. Four patients presented midline necrosis, one pyomyositis after intramuscular injection of cocaine in the neck and another subcutaneous emphysema after cocaine inhalation. The less frequent manifestations were mouth ulcers, pemphigus-like lesions, laryngeal edema or rhinitis.

CONCLUSIONS: The destructive lesions of the midline are the most common presentation of cocaine abuse, others can be observed, where a high index of suspicion of consumption can grant the etiological diagnosis.

KEYWORDS: Cocaine abuse; Mouth, Nose.