Midline Palate Perforation From Cocaine Abuse

Cocaine and oral health

“…12,15,26,35,37,40 Surgical reconstruction of the pal ate failed in five out of ten reported patients. 19,20,26,30,41 In three other patients, the final outcome of the surgical recon struction was unknown because they were lost to follow up within three weeks.…”

“…15 A suc cessful one-year follow up has only been reported for one patient with two bipedi cle mucoperiostous fl aps. 35 An alternative approach is the con struction of a removable maxillary obturator. If a suprastructure is created on the obturator with the dimensions of the palatal defect, this will eliminate the oronasal reflux and restore the speech to normal 18 (Fig.…”

Palate Perforation

“…35 Typically with snorting of cocaine, the nasal septum can erode and disintegrate, with damage extending to cause perforation of the hard and/or soft palate. 36 Although cocaine's effects on the palate are well documented, more recent studies have exposed heroin as another cause of palatal necrosis and perforation. Palatal involvement should always be investigated in drug users when nasal damage is observed.…”

Palatal perforations: past and present. Two case reports and a literature review

“…16 The area of damage extends to cause perforation of the hard and/or soft palate. 17 Ischaemic necrosis of the soft palate musculature can lead to ulceration, infection and retraction with subsequent distortion and paralysis. 16 The mechanism of necrosis is, however, probably multifactorial.…”

“…15 In most cases palatal defects and the floor of the nose are usually grafted using standard cleft palate surgery techniques. 17 For the palate local flaps are the best option wherever possible. 1 A recent case, of congenital syphilis, reported successful repair of a large palatal defect using a tongue flap.…”