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Nasal Cocaine Necrosis
Philip R. Chapman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Nasal cocaine necrosis (NCN)
            • Synonyms

              • Cocaine-induced midline destructive lesions
            • Definitions

              • Destruction of osteocartilaginous structures of nose, sinuses, and palate induced by chronic inhalation of cocaine

            IMAGING

            • General Features

              • Imaging Recommendations

                • CT Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Brembilla C et al: Craniovertebral junction instability as an extension of cocaine-induced midline destructive lesions: case report. J Neurosurg Spine. 23(2):159-65, 2015
                                      2. Laudien M: Orphan diseases of the nose and paranasal sinuses: Pathogenesis - clinic - therapy. GMS Curr Top Otorhinolaryngol Head Neck Surg. 14:Doc 04, 2015
                                      3. D'Amico M et al: An observational study of nasal cavity toxicity in cancer patients treated with bevacizumab. Expert Opin Drug Saf. 13(11):1437-42, 2014
                                      4. Lawrence LA et al: Levamisole-adulterated cocaine induced skin necrosis of nose, ears, and extremities: Case report. Allergy Rhinol (Providence). 5(3):132-6, 2014
                                      5. Albert L Jr et al: Cocaine-induced encephalocele: case report and literature review. Neurosurgery. 68(1):E263-6, 2011
                                      6. Businco LD et al: Psychological aspects and treatment of patients with nasal septal perforation due to cocaine inhalation. Acta Otorhinolaryngol Ital. 28(5):247-51, 2008
                                      7. Valencia MP et al: Congenital and acquired lesions of the nasal septum: a practical guide for differential diagnosis. Radiographics. 28(1):205-24; quiz 326, 2008
                                      8. Di Cosola M et al: Cocaine-related syndrome and palatal reconstruction: report of a series of cases. Int J Oral Maxillofac Surg. 36(8):721-7, 2007
                                      9. Westreich RW et al: Midline necrotizing nasal lesions: analysis of 18 cases emphasizing radiological and serological findings with algorithms for diagnosis and management. Am J Rhinol. 18(4):209-19, 2004
                                      10. Trimarchi M et al: Sinonasal osteocartilaginous necrosis in cocaine abusers: experience in 25 patients. Am J Rhinol. 17(1):33-43, 2003
                                      11. Armstrong M Jr et al: Nasal septal necrosis mimicking Wegener's granulomatosis in a cocaine abuser. Ear Nose Throat J. 75(9):623-6, 1996
                                      12. Allbery SM et al: MR imaging of nasal masses. Radiographics. 15(6):1311-27, 1995
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Nasal cocaine necrosis (NCN)
                                                • Synonyms

                                                  • Cocaine-induced midline destructive lesions
                                                • Definitions

                                                  • Destruction of osteocartilaginous structures of nose, sinuses, and palate induced by chronic inhalation of cocaine

                                                IMAGING

                                                • General Features

                                                  • Imaging Recommendations

                                                    • CT Findings

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Staging, Grading, & Classification

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Brembilla C et al: Craniovertebral junction instability as an extension of cocaine-induced midline destructive lesions: case report. J Neurosurg Spine. 23(2):159-65, 2015
                                                                          2. Laudien M: Orphan diseases of the nose and paranasal sinuses: Pathogenesis - clinic - therapy. GMS Curr Top Otorhinolaryngol Head Neck Surg. 14:Doc 04, 2015
                                                                          3. D'Amico M et al: An observational study of nasal cavity toxicity in cancer patients treated with bevacizumab. Expert Opin Drug Saf. 13(11):1437-42, 2014
                                                                          4. Lawrence LA et al: Levamisole-adulterated cocaine induced skin necrosis of nose, ears, and extremities: Case report. Allergy Rhinol (Providence). 5(3):132-6, 2014
                                                                          5. Albert L Jr et al: Cocaine-induced encephalocele: case report and literature review. Neurosurgery. 68(1):E263-6, 2011
                                                                          6. Businco LD et al: Psychological aspects and treatment of patients with nasal septal perforation due to cocaine inhalation. Acta Otorhinolaryngol Ital. 28(5):247-51, 2008
                                                                          7. Valencia MP et al: Congenital and acquired lesions of the nasal septum: a practical guide for differential diagnosis. Radiographics. 28(1):205-24; quiz 326, 2008
                                                                          8. Di Cosola M et al: Cocaine-related syndrome and palatal reconstruction: report of a series of cases. Int J Oral Maxillofac Surg. 36(8):721-7, 2007
                                                                          9. Westreich RW et al: Midline necrotizing nasal lesions: analysis of 18 cases emphasizing radiological and serological findings with algorithms for diagnosis and management. Am J Rhinol. 18(4):209-19, 2004
                                                                          10. Trimarchi M et al: Sinonasal osteocartilaginous necrosis in cocaine abusers: experience in 25 patients. Am J Rhinol. 17(1):33-43, 2003
                                                                          11. Armstrong M Jr et al: Nasal septal necrosis mimicking Wegener's granulomatosis in a cocaine abuser. Ear Nose Throat J. 75(9):623-6, 1996
                                                                          12. Allbery SM et al: MR imaging of nasal masses. Radiographics. 15(6):1311-27, 1995