Answer:
The injury of cocaine use is a chronic ischemic injury to the nasal
mucosa and perichondrium. This can ultimately cause ischemic necrosis of
the septal cartilage and subsequent septal perforation. More serious problems
include osteocartilagenous necrosis, alar necrosis, and saddle deformity.
Septal perforations require repair with a mucosal flap. More serious necrosis
requires debridement and antibiotic with delayed reconstruction with bone
or cartilage grafts.