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- Title
Maxillofacial osteonecrosis in a patient with multiple "idiopathic" facial pains.
- Authors
Adams, William R.; Spoinek, Kenneth J.; Bouquot, Jerry E.
- Abstract
Previous investigation have identified focal areas of alveolar bone tenderness, increased mucosal temperature , abnormal anesthetic response, radiographic abnormality, increased radioisotope uptake on bone scans, and abnormal marrow with in the quadrant of pain in patients with chronic, idiopathic facial pain. The present case report a 53-year-old man with multiple debilitating, "idiopathic" chronic facial pains, including trigeminal neuralgia and atypical facial neuralgia. At necropsy he was founds to have numerous separate and distinct areas of ischemic osteonecrosis on the side affected by the pains one immediately beneath the major trigger for the lanicinating pain of the trigeminal neuralgia. This disease called NICO (neuralgia-inducing cavitational osteonecrosis) when the jaws are involved, is a variation of the osteonecrosis that occurs in other bones, especially the femur. The underlying problem is vascular insufficiency with intramedullary hypertension and multiple intraosseous infraction occurring over time. The present case report illustrate the extreme difficulties involved in the diagnosis and treatment of this disease.
- Subjects
OSTEONECROSIS; FACIAL pain; BONE marrow; EDEMA; FACIAL neuralgia; OSTEOMYELITIS
- Publication
Journal of Oral Pathology & Medicine, 1999, Vol 28, Issue 9, p423
- ISSN
0904-2512
- Publication type
Report
- DOI
10.1111/j.1600-0714.1999.tb02115.x