Liquid nitrogen Cryotherapy in management of oral lesions

Potentially malignant disease of the oral mucosa, with the risk of conversion to Oral Squamous cell carcinoma (OSCC) is described as premalignant or precursor lesions. The lesions like leukoplakia, erosive lichen planus, retention cysts like mucocele, and hyperplastic growths like traumatic fibroma are predominantly seen intra orally. A prospective study was done on 10 consenting patients to evaluate the effectiveness of open cryosurgical method in treating intra oral lesions with liquid nitrogen. Cotton swabs, 5-10 mm in diameter, were dipped in liquid nitrogen for 1-2 seconds and applied directly to the lesions after local anesthetic infiltration. Each site was directly exposed to 4 or 5 consecutive freeze-thaw cycles. The patients were examined on the 3rd day, 1st week, 2nd week and one month post operatively, to evaluate the parameters like pain, swelling, erythema, sloughing, formation of granulation tissue and epithelization. Atraumatic bloodless procedures which could give same or better results than surgical technique was introduced in the recent past. Cryosurgery is one of the modalities which fulfills these criteria. This technique provides a bloodless field, causes less pain, decreases operating time and causes minimal surgical morbidity. Cotton swab cryotherapy (CSC) with liquid nitrogen has shown significantly good results in achieving complete regression (CR) of the benign and premalignant lesions of the oral cavity.