A 48-year-old female patient presented to the maxillofacial surgery service of the General Hospital of the West of the Health Department Jalisco for presenting a two-month oral-nasal evolution.
This is a married woman, born and resident in Guadalajara, Jalisco, gesta 3, middle-low socioeconomic status, who reports hygienic-dietetic habits regular and non-blind.
She had no previous surgical, transfusional, allergic or hospital history.
Physical examination revealed flat faces, depressed nasal dorsum and wide.
The intraoral examination showed chronic ulcer in hard palate of 15 x 17 mm, asymptomatic, without inflammation data, which according to the patient appeared spontaneously, reporting a slow growth and cause problems when swallowing nasal voice.
Nasal fossa examination revealed destruction of the middle nasal septum.
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Laboratory tests were performed (bilirubin test, blood chemistry, abnormal results).
Computed tomography of the facial area was requested, showing in coronal sections the absence of the middle nasal septum and the destruction of the medial wall of the left maxillary antrum.
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Inflammatory incisional biopsy, necrosis areas, abundant chronic infiltrate and squamous metaplasia of several minor salivary glands were taken.
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With the previous data and suspecting a destruction by cocaine use and not having reported drug addiction, an anti-doping test was requested to reveal the presence of cocaine and cocaine 10 years ago. The patient became an elderly patient with marijuana 10 years ago.
The diagnosis was chronic ulcer due to chronic consumption of cocaine by inhalation.
The patient was treated with the placement of a palatal obturator, referred to psychological care and surgical closure of the fistula was proposed, but no return to subsequent appointments.
