(Received 11 March 1982; accepted 19 April 1982)
Published Online: October
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Examination of three patients who were presented for routine physical examinations revealed significant perforations of the anterior nasal septum. A 26-year-old male and 28-year-old female with this defect have been chronic abusers of cocaine by nasal inhalation. A 69-year-old female showed a similar defect by overuse of a common over-the-counter nasal spray containing the decongestant phenylephrine. Both drugs are powerful vasoconstrictors that reduce blood flow to the local area. With prolonged use there is persistent deprivation to the tissue of oxygen necessary for cell viability, with resultant necrosis. Additionally, the physical irritation from the impingement by these drugs on the nasal membranes further hastens the destructive process. Finally, the tissue breakdown is complete with perforations of various sizes.
Assistant professor, University of Medicine and Dentistry of New Jersey/New Jersey School of Osteopathic Medicine, Camden,
Stock #: JFS12219J