Intranasal acetaminophen induced nasal tissue necrosis and septal perforation: A case report and literature review
Bibliographic record
Abstract
Intranasal abuse of drugs such as cocaine, heroin, and combination opioid/non-opioid medication are well documented in the literature, but intranasal abuse of acetaminophen is rarely described. Here we present a case report of an otherwise healthy 39-year-old female who presented with significant sinus pain, nasal congestion, anosmia, rhinorrhea, throat discomfort and odynophagia five months after starting intranasal abuse of 10 tablets of acetaminophen daily. Anterior rhinoscopy revealed a large and inflamed anterior septal perforation with exposed cartilage. Significant debris and acetaminophen tablet residue was present is both nasal cavities. With Suboxone (buprenorphine/naloxone) therapy, she succeeded in cessation of drug use. Due to her ongoing complaints of nasal obstruction, not resolving with medical management, surgery was arranged. This is the first reported case of intranasal acetaminophen abuse in Canada and the first documented case where suboxone was used to help taper intranasal acetaminophen use prior to surgical intervention.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".