Distribution of cocaine-induced midline destructive lesions: systematic review and classification.
Eur Arch Otorhinolaryngol
; 279(7): 3257-3267, 2022 Jul.
Article
em En
| MEDLINE
| ID: mdl-35138441
ABSTRACT
PURPOSE:
Intranasal cocaine is known to potentially lead to midline destructive lesions. The present systematic review was undertaken to systematically define the localization of cocaine-induced midline destructive lesions and their prevalence and to propose a practical classification of these lesions.METHODS:
A PRISMA-compliant systematic review was performed in multiple databases with criteria designed to include all studies published until March 2021 providing a precise definition of cocaine-induced midline lesions in humans. We selected all original studies except case reports. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for lesion localization, patients' demographics, exposure to cocaine, and relationship with external nose destruction.RESULTS:
Among 2593 unique citations, 17 studies were deemed eligible (127 patients). All studies were retrospective case series. The destructive process determined a septal perforation in 99.2% of patients. The distribution prevalence decreased from the inferior third of the sinonasal complex (nasal floor and inferolateral nasal wall, respectively, 59% and 29.9% of patients) to the middle third (middle turbinate and ethmoid, 22.8% of patients), and ultimately to neurocranial structures (7.9% of patients). Nasal deformities were inconsistently reported across reviewed studies. Cocaine use duration, frequency, and status were reported only occasionally.CONCLUSION:
Based on the distribution prevalence observed, we propose a four-grade destruction location-based classification. Future prospective studies following the evolution of cocaine-induced lesions are needed to validate our classification, its relationship with lesion evolution, and whether it represents a reliable tool for homogeneous research results reporting.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doenças Nasais
/
Cocaína
/
Transtornos Relacionados ao Uso de Cocaína
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article