Velopharyngeal dysfunction from intranasal substance abuse: Case series and review of literature

You, Peng; Chow, Linda; Dworschak-Stokan, Anne; Husein, Murad

doi:10.1002/lary.27240

Cited by 5 publications

(9 citation statements)

References 9 publications

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“…The intranasal route administration was reported by all 7 subjects in our case series and preceded the beginning of the attacks for 5 of them. A repeated intranasal use of irritating products (drugs themselves, adulterants, or excipients) could lead to nasal and oral structures damage . These peripheral orofacial lesions could affect sensitive branches of the trigeminal nerve, generating a nociceptive impulse transmitted until the cortex via the trigeminovascular system (which consists of neurons in the trigeminal nerve that innervate cerebral blood and dural vessels) and participating in pain sensation .…”

Section: Discussionmentioning

confidence: 99%

“…A repeated intranasal use of irritating products (drugs themselves, adulterants, or excipients) could lead to nasal and oral structures damage. 1,48 These peripheral orofacial lesions could affect sensitive branches of the trigeminal nerve, generating a nociceptive impulse transmitted until the cortex via the trigeminovascular system (which consists of neurons in the trigeminal nerve that innervate cerebral blood and dural vessels) and participating in pain sensation. 8 Along with the pain process, a reflex between trigeminal nerve activation (triggered by peripheral lesions) and the parasympathetic system leads to CH autonomic symptoms such as lacrimation, rhinorrhea, or nasal congestion.…”

Section: Discussionmentioning

confidence: 99%

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Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature

et al. 2019

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Objective To describe a case series of 7 patients presenting cluster headache (CH) criteria and a substance use disorder, reported to a French Addictovigilance center. Then, to assess clinical, pharmacological, and neurobiological linkages between substance use and CH onset. Background CH patients are presenting a higher prevalence of comorbidities, among which the use of psychoactive substances, licit or illicit, have been explored by a few authors. Recently, 3 cases of CH in patients seen in the hospital‐based addiction care center have been reported to the Toulouse addictovigilance center. Methods Other cases have been identified in the same tertiary hospital after a collaborative investigation done with the departments of neurology and psychiatry and included in the case series. A narrative review was performed to assess the potential of psychoactive substance consumption to induce or facilitate CH. Results From 2016 to 2018, 6 males and 1 female aged between 26 and 54 years old, presenting CH criteria and a substance use disorder, were included in our case series. Among substances used, there are: (1) daily use of tobacco and alcohol in 5/7 subjects; (2) daily or almost daily use of cocaine in 5/7 subjects; (3) regular use of cannabis before attacks beginning in 4/7 subjects; and (4) opioids, as a substitutive medication or abused, in 5/7 subjects. The intranasal route administration is reported by all the subjects and precedes the beginning of attacks for 5/7 subjects. Conclusions We have found a CH prevalence of 0.9% in our studied population, while it is estimated at 0.1% in the general population. The coexistence of cluster headache and addiction behaviors reflects possible common neurobiological pathways, which would include the hypothalamus. Research could be conducted on the potential of hypothalamic therapeutic targets.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature

et al. 2019

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“…Individuals with substance abuse issues involving the intranasal inhalation of drugs are at risk for oronasal tissue damage such as palatal necrosis (Di Cosola et al, 2007). In cases reported in the literature involving perforations of the soft palate, speech, resonance, and swallowing problems were the major complaints and surgery was implemented; however, a speech appliance is also an option for these individuals (Hofstede & Jacob, 2010;You et al, 2018). For the patient in this case study, perceptual and physiologic speech assessments indicated a positive change in communication with the use of a speech appliance.…”

Section: Treatment Outcomementioning

confidence: 99%

“…A frequently used pathway of drug ingestion is nasal inhalation, which provides for rapid entry into the body. Drugs such as heroin and cocaine are frequently inhaled and there are reports that some individuals develop nasal and oral tissue damage (Hardison et al, 2015;You et al, 2018). The cause of the tissue damage according to Birchenough et al (2007) is vasoconstriction, which is a function of sympathetic stimulation that is triggered by diminished norepinephrine and epinephrine chemical re-absorption.…”

mentioning

confidence: 99%

Treating Velopharyngeal Insufficiency in a Case of Substance Abuse: A New Client Population

Ruscello

Armeni

2022

Perspect ASHA SIGs

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Objective A case study is presented to illustrate the management of a patient who presented with significant tissue damage of the soft palate due to substance abuse, which involved the inhalation of drugs. Method The patient was seen in a university medical center cleft palate clinic upon referral from a mental health facility with reported speech and swallowing problems. Perceptual and physiologic speech testing, a behavioral swallowing assessment, and other interdisciplinary assessments were conducted to confirm the patient's complaints and develop a treatment plan. Results A speech appliance was fabricated to correct the defect and follow-up testing showed improvement in both speech and swallowing skills. Perceptual assessment indicated improved resonance balance and reduction in audible nasal emission, while physiologic testing revealed decreased nasal airflow. The team successfully implemented a plan to correct the patient's speech, resonance, and swallowing problems. Conclusions Substance abuse is now a significant national crisis and patients may need a range of services depending on their complex of problems. Some individuals may need assistance with speech, resonance, and swallowing disorders and require prosthetic intervention provided via interdisciplinary management from a cleft palate team.

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“…Cuando el daño producido por el consumo de cocaína vía intranasal afecta a la musculatura velofaríngea, puede dar lugar a una insuficiencia velopalatina. Esta consiste en un defecto de cierre entre la oro y nasofaringe, a cargo del esfínter conformado por el músculo constrictor superior de la faringe y el paladar blando [99][100][101][102][103][104][105].…”

Section: Insuficiencia Velopalatinaunclassified

Manifestaciones de cabeza y cuello secundarias al uso de cocaína. Revisión bibliográfica

Corriols-Noval

Palmero-Sánchez

Faelens³

et al. 2022

ORL

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Introducción y objetivo: El consumo de cocaína se ha asociado a patología a múltiples niveles, pero ésta es especialmente relevante a nivel de cabeza y cuello, por ser la vía intranasal una de sus más frecuentes vías de consumo. Este trabajo describe las principales manifestaciones clínicas del consumo de cocaína en el área otorrinolaringológica, y se analizan algunos de los diagnósticos diferenciales que se han de descartar. Método: Se realizó una revisión bibliográfica vía, PubMed, Cochrane y Google Schoolar con artículos publicados entre 1999 y 2019 con la palabra cocaine junto con diferentes términos de búsqueda, siguiendo los criterios PRISMA para la selección de artículos. Resultados: La búsqueda inicial redujo los artículos a 641, finalizando la selección en 63 artículos, a los cuales se añadieron otros 66 desde otras fuentes. Finalmente, 129 artículos fueron incluidos en la presente revisión sistemática. Conclusiones: La necrosis de la línea media y la perforación septal son las manifestaciones más frecuentemente descritas asociadas al abuso de cocaína. Sin embargo, esta sustancia puede originar otras muchas lesiones en cabeza y cuello, generalmente de difícil diagnóstico, sobre todo cuando el paciente niega el abuso de sustancias.

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Velopharyngeal dysfunction from intranasal substance abuse: Case series and review of literature

Abstract: 4. Laryngoscope, 2018.

Cited by 5 publications

References 9 publications

Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature

Cluster Headache in Subjects With Substance Use Disorder: A Case Series and a Review of the Literature

Treating Velopharyngeal Insufficiency in a Case of Substance Abuse: A New Client Population

Manifestaciones de cabeza y cuello secundarias al uso de cocaína. Revisión bibliográfica

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