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Cocaine-associated Eustachian tube stenosis causing chronic ‘glue ear’: a rare cocaine-induced destructive lesion

Published online by Cambridge University Press:  08 February 2024

Talib Dar Open the ORCID record for Talib Dar [Opens in a new window] ,
Michel Abou-Abdallah Open the ORCID record for Michel Abou-Abdallah [Opens in a new window] ,
Joshua Michaels  and
Rishi Talwar
Talib Dar*
Affiliation:
ENT Department, Luton and Dunstable University Hospital, Luton, UK
Michel Abou-Abdallah
Affiliation:
ENT Department, Luton and Dunstable University Hospital, Luton, UK
Joshua Michaels
Affiliation:
ENT Department, Luton and Dunstable University Hospital, Luton, UK
Rishi Talwar
Affiliation:
ENT Department, Luton and Dunstable University Hospital, Luton, UK
*
Corresponding author: Talib Dar; Email: talib.dar@nhs.net
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Abstract

Background

Cocaine is one of the most used recreational drugs. Whilst medical uses exist, chronic recreational nasal use of cocaine is associated with progressive destruction of the osseocartilaginous structures of the nose, sinuses and palate – termed cocaine-induced midline destructive lesions.

Case report

A 43-year-old male with a history of chronic cocaine use, presented with conductive hearing loss and unilateral middle-ear effusion. Examination under anaesthesia revealed a completely stenosed left Eustachian tube orifice with intra-nasal adhesions. The adhesions were divided and the hearing loss was treated conservatively with hearing aids. Whilst intra-nasal cocaine-induced midline destructive lesions are a well-described condition, this is the first known report of Eustachian tube stenosis associated with cocaine use.

Conclusion

This unique report highlights the importance of thorough history-taking, rhinological and otological examination, and audiometric testing when assessing patients with a history of chronic cocaine use. This paper demonstrates the complexity of managing hearing loss in such cases, with multiple conservative and surgical options available.

Keywords

nosenose deformitiesacquiredcocaineearearmiddleEustachian tubeotitis mediahearing lossnasal surgical proceduresotolaryngology
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 6 , June 2024 , pp. 699 - 702
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Talib Dar takes responsibility for the integrity of the content of the paper

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