(1204) Adjuvant Treatment with Pentoxifyline in Patients with CIMDL: Experience in a Rhinology Service

Introduction: CIMDL is characterized by progressive and necrotizing inflammatory injury of the nasal septum and midline structures, related to chronic intranasal cocaine use. The pathophysiology encompasses ischemia, autoimmune responses (including ANCA-HNE), and secondary infections. Treatment remains challenging, and there is limited evidence supporting adjuvant therapies that may reduce chronic inflammation and recurrence.

Methods: A prospective clinical study was conducted with 8 patients (5 male, 3 female; mean age 40 years) durante the year 2024, attending a tertiary outpatient otolaryngology clinic. All patients underwent sinonasal surgical debridement and received pentoxifylline 800 mg daily (400 mg BID) starting 30 days pre-operatively and continued for 90 days post-operatively (total treatment 120 days). Mean follow-up was 6 months. Outcomes were assessed clinically through endoscopy and standardized physician-reported documentation.

Results: All patients demonstrated clinically significant improvement in postoperative healing, with reduced nasal crusting and a marked decrease in the recurrence of secondary infections. No adverse effects or treatment interruptions were observed. There were no cases of worsening necrosis or need for unscheduled revision surgery during follow-up.

Conclusions: Pentoxifylline was well tolerated and may contribute to improved postoperative clinical outcomes in CIMDL, particularly regarding crusting control and infection reduction. Although limited by small sample size, these results support further controlled clinical studies to establish the role of pentoxifylline in standardized treatment protocols for CIMDL.