Allard Felicia D, Yee Eric U, Freitag Suzanne K
Department of Pathology, Beth Israel Deaconess Medical Center, Boston , Massachusetts , USA and.
Orbit. 2013 Dec;32(6):405-8. doi: 10.3109/01676830.2013.815225. Epub 2013 Aug 2.
To report a case of dacryocystitis secondary to intranasal cocaine abuse and to review the literature on the effects of cocaine on sinus, nasal and lacrimal structures.
Case report and literature review.
A 33-year-old male presented with unilateral epiphora and discharge, and clinical examination was consistent with dacryocystitis. He had a 2-year history of intranasal cocaine use. Computed tomography revealed extensive bilateral intranasal and sinus destruction, consistent with cocaine abuse. He was treated with antibiotics followed by dacryocystorhinostomy with silicone intubation. He had 2 recurrences of dacryocystitis and underwent one additional lacrimal surgery.
Cocaine abuse and its accompanying intranasal and sinus destruction should be considered when determining the etiology of nasolacrimal obstruction and dacryocystitis. A medical and social history with specific questions about drug abuse may be useful. Computed tomography is helpful in delineating damage to the sinuses, nose and lacrimal system. Management with antibiotics and dacryocystorhinostomy surgery may result in resolution of symptoms.
报告一例因鼻内滥用可卡因继发泪囊炎的病例，并回顾关于可卡因对鼻窦、鼻腔和泪器结构影响的文献。
病例报告及文献回顾。
一名33岁男性出现单侧溢泪和分泌物增多，临床检查符合泪囊炎表现。他有2年鼻内使用可卡因的病史。计算机断层扫描显示双侧鼻腔和鼻窦广泛破坏，符合可卡因滥用情况。给予抗生素治疗，随后行泪囊鼻腔吻合术并置入硅胶管。他的泪囊炎复发2次，又接受了一次泪器手术。
在确定鼻泪管阻塞和泪囊炎的病因时，应考虑可卡因滥用及其伴随的鼻腔和鼻窦破坏情况。询问有关药物滥用的特定问题的病史和社会史可能会有帮助。计算机断层扫描有助于明确鼻窦、鼻腔和泪器系统的损伤情况。抗生素治疗及泪囊鼻腔吻合术可能会使症状缓解。
