【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

10 12月

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

The differential diagnosis of a nasal septal perforation includes trauma, surgery, inflammatory/granulomatous diseases, and cocaine abuse.

Cocaine abuse may lead to destructive changes of the nasal septum, paranasal sinuses, turbinates, and the hard palate.

Cocaine abuse may result in inflammatory and fibrotic changes that contribute to dacryocystitis.

鼻中隔穿孔的鉴别诊断包括手术,创伤,炎性/肉芽肿性病变和滥用可卡因

滥用可卡因可导致鼻中隔,鼻旁窦,鼻甲和硬腭的骨质破坏

滥用可卡因可导致炎症和纤维化,引起泪囊炎

Cocaine可卡因

Cocaine increases the activity of monoamine neurotransmitters (dopamine, norepinephrine, and serotonin) in the central and peripheral nervous systems by blocking the presynaptic reuptake transporter pumps. Dopaminergic effects have been proposed to account for euphoria and the addiction associated with cocaine use. Cocaine may be inhaled or administered intravenously. In the inhaled form, cocaine-induced vasoconstriction causes mucosal ischemia, which leads to necrosis and perforation with chronic use.

可卡因通过阻断突触前重摄取转运蛋白泵,导致中枢和外周神经系统的单胺类神经递质(多巴胺,去甲肾上腺素,5-羟色胺)活性增加,多巴胺效应的提出解释了滥用可卡因所致的兴奋和成瘾。可卡因可吸入或静脉注射,在吸入使用时,可卡因诱导血管收缩使粘膜局部缺血,长期使用导致坏死穿

 Nasal septal perforation     鼻中隔穿孔  

The differential diagnosis of nasal septal perforation includes the consequence of prior operative interventions. Other causes include granulomatous/infectious processes, including granulomatosis with polyangiitis (formerly known as Wegener granulomatosis), sarcoidosis, tuberculosis, and syphilis. Sinonasal malignancy such as lymphoma is another possible etiology. Necrosis and the destruction of sinonasal structures such as the ethmoid air cells, turbinates, maxillary walls, and the hard palate have also been described with cocaine abuse. Cocaine abuse may present as pansinusitis, and inflammation of the nasolacrimal sac (dacryocystitis) is also associated with abuse due to chronic obstruction of the nasolacrimal duct.

鼻中隔穿孔的鉴别诊断包括术前干预以及肉芽肿性或感染性疾病。肉芽肿性或感染性疾病包括肉芽肿性多血管炎(旧称Wegner肉芽肿),结节病,结核和梅毒。鼻腔鼻窦的恶性肿瘤如淋巴瘤也可能是病因之一。可卡因滥用引起粘膜坏死和鼻窦结构(如筛窦气房,鼻甲,上颌窦,硬腭)的骨质破坏。可卡因滥用可表现为全鼻窦炎,鼻泪管炎(泪囊炎)与滥用导致的鼻泪管慢性阻塞有关

【病例】滥用可卡因致鼻中隔穿孔、全鼻窦炎、泪囊炎1例CT

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