The most effective treatment for cocaine abusers is obviously cessation of addiction. In the presence of minimal lesions, conservative treatment aimed at removing crusts and necrotic tissue and moistening mucosa, includes the use of saline solution irrigations and emollients. Bacterial infection, which is mostly due to Staphylococcus aureus, is treated by topical or systemic antibiotics, according to cultures. Whenever major destruction is present, no reconstructive surgery should be planned until cocaine abuse has been ceased and the lesion has remained stable for at least 1 year (LANcAstEr et al. 2000). Pedicled or revascularized free flaps could warrant a good functional and aesthetic outcome. Hard palate perforation could benefit from the ap plication of an obturator prosthesis, that may reduce negative effects of oronasal reflux (Mari et al. 2002;
Trimarchi et al. 2003).
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