Neuralgia Inducing Cavitational Osteonecrosis (NICO) - it does exist
Neuralgia Inducing Cavitational Osteonecrosis (NICO) - despite what the "experts" say it does exist, but is hard to treat.
NICO lesions or cavitations are hollow places in jaw bones. These hollow areas may never cause pain or a problem. However, cavitations can produce trigeminal pain, headaches, and facial pain. Cavitations are common in all bones that have bone marrow. Many cavitations linger for years without producing facial pain.
Patients with NICO lesions often have the following characteristics:
- approximately 72% have some sort of clotting or vascular abnormality,
- 71% are 35-64 years old (range 18-94 years),
- 75% are in women,
- Patients experience pain prior to diagnosis for average of 6 years (range 1 hour- 32 years).
- Location in mandibular molars (45% 3rd molar region), maxillary molars, and maxillary cuspids / lateral incisors.
Treatment involves surgery, with decortication and curettage of diseased marrow however up to one third of these lesions does not respond to surgery.
