BMJ Case Reports 2013; doi:10.1136/bcr-2013-010450

An unusual oro-naso-sinus communication resulting from heroin and cocaine snorting

  1. George M Abraham
  1. Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  1. Correspondence to Dr Lovely Chhabra, lovids{at}


A 28-year-old woman with a history of snorting heroin and cocaine was admitted with facial cellulitis secondary to a dental phlegmon. She reported rhinolalia, occasional nasal regurgitation of food and a burning sensation in her nose and throat while eating. She self-medicated with a topical application of crushed acetaminophen and oxycodone tablets to her throat to prevent discomfort while eating.

Physical examination revealed poor dentition, palatal destruction, absent soft palate and a white …

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