[Midfacial necrosis secondary to cocaine-abuse]

Area of Science:

• Otolaryngology
• Pathology
• Toxicology

Background:

• Midline destructive diseases encompass a range of conditions affecting the central face.
• Differential diagnosis often includes autoimmune diseases, infections, and malignancies.
• The role of substance abuse in causing such destructive lesions is increasingly recognized.

Observation:

• A 40-year-old male presented with nasosinusal tract necrosis and optic neuropathy.
• The patient reported a history of over 20 years of inhaled cocaine abuse.
• Clinical presentation suggested a midline destructive process.

Findings:

• Histopathological examination confirmed midfacial necrosis.
• The necrosis was directly attributed to chronic inhaled cocaine abuse.
• This presentation represents a distinct clinical entity.

Implications:

• Cocaine-induced midfacial necrosis should be considered in the differential diagnosis of midline destructive diseases.
• Early recognition and cessation of cocaine use are crucial for patient outcomes.
• This entity expands the spectrum of known complications associated with inhaled cocaine abuse.