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Purpose <p>This study evaluates the impact of nasal septal perforation (NSP) due to recreational intranasal cocaine use on quality of life (QoL), comparing it with NSPs from other causes using both disease-specific and generic QoL instruments.</p> Methods <p>A prospective observational study was conducted from 2017 to 2024 acrosstwo referral centres.</p> Results <p>A total of 152 patients with NSP were included, of whom 93 (61.2%) were male and 57 (37.5%) cocaine-related NSP. Cocaine-induced perforations showedlarger antero-posterior (mean 27.1 mm, SD 12.2) and super-inferior (mean 18.6 mm, SD 7.5) diameters, as well as greater surface area compared to other aetiologies (<i>p</i> &lt; 0.001 for all comparison). Nasal obstruction, rhinorrhoea and crusts were the most severe symptoms reported via visual analogue scale (VAS) scores in both groups.Cocaine-induced NSPs reported worse SNOT-22 (mean 53.9 vs. 42.8; <i>p</i> = 0.004), particularly in Emotion, Sleep and Nasal. SEPEQOL item #12 (“aesthetic changes inmy nose”) was reported as problematic by 57.8% cocaine users, with 80.8% rating it as fairly bad to a severe issue. Mental health outcomes were worse in the cocaine group based on SF-36 scores (<i>p</i> = 0.003). NSP-specific questionnaires (NOSE-Perf and SEPEQOL) demonstrated a similar impact on QoL across both groups.</p> Conclusion <p>NSP negatively impairs sinonasal symptoms and QoL. Cocaine-induced NSPs are associated with more severe anatomical damage and greater psychosocial burden. A comprehensive assessment addressing both physical and psychological aspects is essential for accurate diagnosis and effective management.</p>

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When recreation turns risky: the multifaceted negative impact of cocaine-induced nasal septal perforations

  • 期刊论文

  • 发表日期：

    2025年11月25日

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  • Berta Alegre Edo,
  • María Jesús Rojas-Lechuga,
  • Mauricio Lopez-Chacón,
  • Camilo Rodríguez-Van Strahlen,
  • Manuel Bernal-Sprekelsen,
  • Isam Alobid

摘要

Purpose

This study evaluates the impact of nasal septal perforation (NSP) due to recreational intranasal cocaine use on quality of life (QoL), comparing it with NSPs from other causes using both disease-specific and generic QoL instruments.

Methods

A prospective observational study was conducted from 2017 to 2024 acrosstwo referral centres.

Results

A total of 152 patients with NSP were included, of whom 93 (61.2%) were male and 57 (37.5%) cocaine-related NSP. Cocaine-induced perforations showedlarger antero-posterior (mean 27.1 mm, SD 12.2) and super-inferior (mean 18.6 mm, SD 7.5) diameters, as well as greater surface area compared to other aetiologies (p < 0.001 for all comparison). Nasal obstruction, rhinorrhoea and crusts were the most severe symptoms reported via visual analogue scale (VAS) scores in both groups.Cocaine-induced NSPs reported worse SNOT-22 (mean 53.9 vs. 42.8; p = 0.004), particularly in Emotion, Sleep and Nasal. SEPEQOL item #12 (“aesthetic changes inmy nose”) was reported as problematic by 57.8% cocaine users, with 80.8% rating it as fairly bad to a severe issue. Mental health outcomes were worse in the cocaine group based on SF-36 scores (p = 0.003). NSP-specific questionnaires (NOSE-Perf and SEPEQOL) demonstrated a similar impact on QoL across both groups.

Conclusion

NSP negatively impairs sinonasal symptoms and QoL. Cocaine-induced NSPs are associated with more severe anatomical damage and greater psychosocial burden. A comprehensive assessment addressing both physical and psychological aspects is essential for accurate diagnosis and effective management.