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Article
April 1987

Closure of Septal Perforations

Author Affiliations

Vienna, Va

Arch Otolaryngol Head Neck Surg. 1987;113(4):438-439. doi:10.1001/archotol.1987.01860040100034
Abstract

To the Editor.—In the December 1986 issue of the Archives,1 there was an article on surgical closure of nasoseptal perforations. The author described several techniques for achieving closure of nasoseptal perforations and mentioned intranasal cocaine abuse as a possible cause.

Prior to closure of septal perforations, otolaryngologists should inquire about possible frequent intranasal use of cocaine or methamphetamine.2 In addition to inquiry, it is important to order a urine toxicology screen for cocaine and amphetamines by enzyme immunoassay (EMIT) or radioimmunoassay and not by the less sensitive thin-layer chromatography technique, used to perform most "tox screens." A positive screening test should be confirmed by a more specific and at least equally sensitive chromatography technique. A positive test for either drug should stay the hand of the surgeon until the drug abuser has been abstinent, by repeatedly "clean" urine specimens, for at least one year.

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