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Neurosensory changes after liquid nitrogen cryotherapy.

Brian L Schmidt1, M A Pogrel

  • 1Department of Oral and Maxillofacial Surgery, University of California-San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0440, USA. briansc@itsa.ucsf.edu

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|September 29, 2004
PubMed
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Liquid nitrogen cryotherapy combined with enucleation for mandibular lesions showed minimal inferior alveolar nerve alteration. Most patients experienced temporary paresthesia, with significant sensation return within months.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Neurology
  • Oncology

Background:

  • Mandibular lesions require effective treatment while preserving vital structures.
  • The inferior alveolar nerve is susceptible to injury during mandibular procedures.
  • Cryotherapy offers a minimally invasive approach for lesion management.

Purpose of the Study:

  • To assess neurosensory changes following liquid nitrogen cryotherapy for mandibular lesions near the inferior alveolar nerve.
  • To evaluate the safety and efficacy of cryotherapy in conjunction with enucleation.

Main Methods:

  • Retrospective review of 16 patients with posterior mandibular lesions (odontogenic keratocysts and fibromyxoma).
  • Standardized enucleation and liquid nitrogen cryotherapy technique applied.

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  • Postoperative assessment included patient-reported symptoms and formal neurosensory testing.

    • Main Results:

    • All patients experienced altered sensation (anesthesia or paresthesia) immediately post-cryotherapy.
    • Average return of sensation occurred at 91 days; no patients had anesthesia or dysesthesia at long-term follow-up.
    • 12 patients had paresthesia, and 4 had full sensation return; 9 had full or near-full recovery.

    Conclusions:

    • Enucleation combined with liquid nitrogen cryotherapy results in minimal long-term alteration of inferior alveolar nerve function.
    • The treatment modality demonstrates a favorable safety profile regarding neurosensory deficits.