Cocaine-Induced Midline Destructive Lesions: A Historical Review of Diagnostic Mimicry.

This historical review of cocaine-induced midline destructive lesions (CIMDL) traces the evolution of our understanding of cocaine-related sinonasal injury and the prolonged diagnostic confusion surrounding destructive midline disease. From the rapid adoption of topical cocaine anesthesia, through decades of nosological debate, to the levamisole adulteration era that eroded the specificity of serological tools, the review culminates in a practical diagnostic framework for contemporary clinical practice.