2. CryosurgeryCryosurgery
Cryosurgery is a procedureCryosurgery is a procedure
using freezing temperature tousing freezing temperature to
destroy the tissue. (destroy the tissue. (done bydone by
liquid nitrogen or nitrousliquid nitrogen or nitrous
oxideoxide))
3. CryosurgeryCryosurgery
-15°C is necessary to produce intra--15°C is necessary to produce intra-
cellular ice formationcellular ice formation
-50°C is advocated for the-50°C is advocated for the
destruction of malignant neoplasmsdestruction of malignant neoplasms
liquid nitrogen probes reach aliquid nitrogen probes reach a
temperature of approximatelytemperature of approximately
-180°C and a spray -198°C-180°C and a spray -198°C
4. CryoprobesCryoprobes
A cryoprobe is surgical instrumentA cryoprobe is surgical instrument
with a cold tip.with a cold tip.
The temperature is determined byThe temperature is determined by
the boiling point of the refrigerantthe boiling point of the refrigerant
liquid .liquid .
5. Probe tips come in a variety ofProbe tips come in a variety of
shapes and sizesshapes and sizes..
6. Uses of cryosurgery in oralUses of cryosurgery in oral
surgerysurgery
Ablation of warts and smallAblation of warts and small
tumourstumours healing is usually goodhealing is usually good
with minimal scarring.with minimal scarring.
Ablation of haemangiomasAblation of haemangiomas hashas
the advantage that there is nothe advantage that there is no
haemorrhage and the surface mayhaemorrhage and the surface may
be left intact.be left intact.
7. Uses of cryosurgery in oralUses of cryosurgery in oral
surgerysurgery
Treatment of bony cavitiesTreatment of bony cavities
reduce recurrence of lesions suchreduce recurrence of lesions such
asas odontogenic keratocystsodontogenic keratocysts oror
central giant cell granulomacentral giant cell granuloma..
Blocking of nervesBlocking of nerves the mostthe most
common condition treated in thiscommon condition treated in this
way isway is trigeminal neuralgiatrigeminal neuralgia that nothat no
longer responds to therapy withlonger responds to therapy with
drugsdrugs..
8. Cryosurgery techniquesCryosurgery techniques
local anaesthesialocal anaesthesia
the probe is applied to thethe probe is applied to the
lesion and switched onlesion and switched on
The probe is held firmlyThe probe is held firmly
onto the lesion until an ice-onto the lesion until an ice-
ball formsball forms
The time of application willThe time of application will
usually be about 1 minusually be about 1 min
9. Cryosurgery techniquesCryosurgery techniques
The probe should not be pulled awayThe probe should not be pulled away
On turning the machine off thereOn turning the machine off there
should be a rapid thaw and the probeshould be a rapid thaw and the probe
is released.is released.
One or two further applications areOne or two further applications are
made after 1 minmade after 1 min
a water-soluble gel may be used toa water-soluble gel may be used to
aid contact with the bone surface.aid contact with the bone surface.
10. AdvantagesAdvantages
No haemorrhageNo haemorrhage
MinimalMinimal
postoperative painpostoperative pain
Good recovery ofGood recovery of
nerve functionnerve function
Minimal scarringMinimal scarring
Bone structureBone structure
maintainedmaintained
Blood vesselBlood vessel
recoveryrecovery
Adjacent normalAdjacent normal
tissues recovertissues recover
Excellent forExcellent for
haemangiomashaemangiomas
Possible treatmentPossible treatment
of painful nerveof painful nerve
lesionslesions
11. DisadvantagesDisadvantages
Cannot be used to cutCannot be used to cut
tissuestissues
Difficulty in assessingDifficulty in assessing
extent of treatmentextent of treatment
Excessive swellingExcessive swelling
(could endanger(could endanger
airway)airway)
Effects at the peripheryEffects at the periphery
(dysplastic changes(dysplastic changes
can be potentiated)can be potentiated)
Whole lesion notWhole lesion not
available foravailable for
pathologypathology
Tumour growthTumour growth
may bemay be
acceleratedaccelerated
Not effective forNot effective for
lymphangiomaslymphangiomas