Schweitzer V G
Laryngoscope. 1986 Feb;96(2):206-10. doi: 10.1288/00005537-198602000-00016.
Recreational cocaine abuse via intranasal "snorting," "free-base" smoking, "body-packing," or intravenous injection can be lethal. Increasing illicit use of cocaine hydrochloride and the misuse of legal over-the-counter (OTC) nasal drugs are known causative agents of nasal septal perforation with loss of taste and smell. Although 2 to 3 mg/kg is the recommended maximum dose for topical anesthesia, cocaine snorters may use 1,000 mg or more daily on a "run." Furthermore, the newer route of smoking the extracted volatile "free-base" form of the adulterated street drug provides a plasma concentration producing the same physiological and subjective effects of intravenous cocaine. Presented are two cases exemplifying unusual complications of cocaine abuse: 1. total nasal septal bony and cartilaginous necrosis with resultant saddle-nose deformity and osteolytic sinusitis secondary to chronic intranasal "snorting" and 2. tracheobronchial rupture with pneumomediastinum secondary to smoking "free-base" cocaine.
通过鼻内“吸食”、“吸服游离碱”、“人体藏毒”或静脉注射等方式滥用娱乐性可卡因可能会致命。盐酸可卡因非法使用的增加以及合法非处方（OTC）鼻用药物的滥用是导致鼻中隔穿孔并伴有味觉和嗅觉丧失的已知病因。虽然局部麻醉的推荐最大剂量为2至3毫克/千克，但吸食可卡因者在“一次使用期”内每天可能会使用1000毫克或更多。此外，吸食提纯的挥发性“游离碱”形式的掺假街头毒品这种较新的途径所产生的血浆浓度，会产生与静脉注射可卡因相同的生理和主观效果。本文介绍了两例可卡因滥用引发异常并发症的病例：1. 因长期鼻内“吸食”导致鼻中隔完全性骨和软骨坏死，进而出现鞍鼻畸形和溶骨性鼻窦炎；2. 因吸食“游离碱”可卡因导致气管支气管破裂并伴有纵隔气肿。
