CIMDLCocaine-Induced Midline Destructive Lesions
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For the purpose of this article, a patient is considered to have a CIMDL if he or she has at least two of these three conditions: (1) a nasal septal perforation, (2) lateral nasal wall destruction of the inferior or middle turbinate in the maxillary or ethmoid sinus, or (3) hard palate involvement, either clinically or radiographically.
Several factors are involved in the pathophysiology of a CIMDL.
In addition, we also believe that cocaine's effect on both the immune system and nasal mucociliary transport rates plays an important role in the pathophysiology of CIMDL, although this is not generally stated in the literature.