Cryodestruction, as a method of cryosurgery, is an effective minimally invasive treatment for benign and malignant growths on the skin and mucous membranes, as well as internal organs. The procedure involves the controlled rapid freezing of pathologically altered tissues using liquid nitrogen, which has a very low boiling point of -196°C, followed by a slow thawing of the frozen area. Cryodestruction is considered a surgical method and is most commonly used in otorhinolaryngology, dermatology, cosmetology, aesthetic medicine, gynecology, and abdominal surgery.
Cryodestruction is one of the most popular methods for treating a wide range of skin neoplasms such as warts, papillomas, condylomas, and other skin issues. This method can also be used to remove pathological vascular or pigmented lesions.
Cryodestruction is used for the treatment of a wide range of diseases.
In otorhinolaryngology: cryodestruction of the palatine tonsils, lymphoid granules in chronic tonsillitis and pharyngitis, treatment of snoring. In gynecology: cervical erosion, dysplasia, condylomas, ectopy of cylindrical epithelium, leukoplakia, and other pathologies.
This modern technique allows in many cases to replace surgical intervention. Cryodestruction is performed using special cryosurgical devices and instruments, the metallic surgical tip of which can be cooled using liquid nitrogen to a temperature of -190°C.
Cryodestruction of the underlying tissues occurs in three successive phases:
• Cryoporation - macroscopic changes in tissue color with swelling, and changes in innervation due to the low temperature treatment.
• Cryonecrosis phase - ischemia followed by necrosis due to complete thrombosis of the vessels.
• Repair - restoration of the normal epithelial layer.
As a result of rapid cooling, the skin becomes firm, pale, and cold, and sensitivity is lost. During this time, tingling, mild burning, and slight discomfort may be felt. Then, collateral swelling and hyperemia appear. This stage may last from 1 to 3 hours, after which an epidermal blister with necrotic fluid forms and then a scab. The blister absorbs within several days. Over a period of 2 to 6 weeks, full necrosis detachment occurs. At the site of cryodestruction, a small, usually pink spot remains, with full organotypic tissue regeneration occurring over a period of 6 months.
Cryodestruction can be performed using either a contact or non-contact method of cooling tissues:
• Contact method – involves direct contact with the tissue cooled by liquid nitrogen.
• Non-contact method – involves the application of a cryogenic stream of nitrogen to the pathological area using a cryosprayer.
Advantages of cryodestruction:
• The cryodestruction site is clearly delineated from surrounding tissues and has "biological inertness," causing only minimal peri-focal reactions in the surrounding tissues.
• Local freezing of tissue is usually performed without significant damage to healthy cells around the necrosis site.
• Painless local cryogenic impact on living tissues, related to the rapid destruction of sensitive nerve endings under cooling.
• Bloodless nature of cryosurgical interventions.
• High resistance of the walls of large vessels to low temperatures, ensuring normal blood flow restoration even after complete freezing (this allows cryodestruction of altered tissues close to these vessels safely).
• Controlled dosing of the degree of destruction.
• Complete (organotypic) regeneration of tissues subjected to cryo-therapy.
• Cryodestruction does not cause rough scarring.
• Activation of the immune system functions.
• Minimal number of complications.
Contraindications for the procedure include acute infectious diseases and the presence of inflammatory processes. In some cases, the procedure cannot be used due to the large size of the neoplasm or when pathological changes occur in difficult-to-reach areas.