口腔粘膜瘤に対する凍結手術の効果と適応症の分析

Analysis of effects and indications of cryosurgery for oral mucoceles.

• Naoko Tsunoda
• Tadashi Kawai
• Mizuki Obara
• Shuu Suzuki
• Ikuya Miyamoto
• Yasunori Takeda
• Hiroyuki Yamada

抄録

凍結手術は口腔内の粘膜瘤の治療法として認知されている。本研究では，口唇または頬粘膜の粘膜瘤に対して凍結手術を行い，その効果と適応を臨床的に評価した．対象は口唇または頬粘膜の粘膜瘤と臨床診断された患者で，病変部の外科的切除と凍結手術の両方の手順を説明した上で凍結手術を選択した患者である．凍結手術は局所麻酔なしで液体窒素を用いた凍結装置を用いて行った。凍結手術を選択したのは24例で，そのうち未就学児7例が含まれていた。凍結手術中と手術後の重篤な有害事象はなかった。凍結手術後の治癒の進行は、患者の年齢、病変の大きさ、病変の期間に影響されなかった。2例は凍結手術が成功しなかったために外科的切除を行った。外科的切除を選択したのは23例で、1例は再発していた。凍結手術を選択した若年層の患者数は、外科的切除を選択した患者数よりも有意に多かった。この研究から，凍結手術は口唇粘膜や頬粘膜の粘膜炎に有効であり，特に未就学児にとっては簡単で安全な治療法であることが示唆された．

Cryosurgery is a recognized method for the treatment of mucoceles in the oral cavity. In this study, cryosurgery was used for mucoceles at the lip or buccal mucosa, and the effect and the indication were evaluated clinically. The subjects were patients with a clinical diagnosis of mucocele on the lip or buccal mucosa and who chose cryosurgery after procedures for both surgical excision and cryosurgery for the lesion were explained. Cryosurgery was performed with a freezing device using liquid nitrogen without local anesthesia. Twenty-four patients chose cryosurgery, including seven preschool children. There were no serious adverse events during and after cryosurgery. Healing progress after cryosurgery was not affected by patient age, lesion size, or how long the patients had the lesion. Two cases later underwent surgical excision because cryosurgery was not successful. Twenty-three patients chose surgical excision, one case had a recurrence. The number of younger patients who chose cryosurgery was significantly higher than that who chose surgical excision. This study suggests that cryosurgery is effective for mucoceles of the lip or buccal mucosa and is a simple and safe treatment method, especially for preschool children.

Copyright © 2020. Published by Elsevier Masson SAS.