Phenolisation as a mode of treatment of mucosal cysts.

Mucous cysts are one of the common cystic lesions of minor salivary glands seen mostly on mucous surface of lower lip and buccal mucosa. Many modalities of treatment for mucosal cysts exist including excision and suturing, deroofing, marsupialization, radiosurgery and cryotherapy. We have used 88% phenol as a mode of treatment of mucosal cysts.

INTRODUCTION

Mucosal cysts of the minor salivary glands are oral soft-tissue lesions that arise as dome-shaped swellings seen commonly on mucosal surface of lower lips and buccal mucosa. Small and superficial lesions do not need treatment as they heal after spontaneous rupture. Many modalities of treatment for mucosal cysts exist, including excision and suturing, deroofing,[1] marsupialisation, radiosurgery and cryotherapy.[23] We have found good results with use of 88% phenol.

Four patients of age between 9 and 25 years were treated between June and December 2011. A male patient aged 9 years had a dome-shaped smooth, tense, bluish cyst of size 5 mm on the lower lip. The second patient was a female aged 24 years, with a mucosal cyst of 4 mm on the buccal mucosa. The third patient, a female aged 21 years, had a lesion of size 6 mm in the buccal mucosa. The fourth patient was a male patient aged 25 years, who had a recurrent mucosal cyst [Figure 1] in the buccal mucosa which was treated 10 months back by electrocautery.

Figure 1

Mucosal cyst on buccal mucosa

Relevant laboratory tests were done prior to the procedure. No local anaesthesia was used. Under aseptic precautions, a very small quantity of 88% phenol was injected into the cyst cavity using insulin syringes [Figure 2]. No dressing was given afterwards. Patients were given analgesics post procedure for 1 day.

Figure 2

Injection of 0.1cc of 88% phenol into cyst

The procedure was uneventful in all the cases. Two of the patients complained of slight burning sensation during the procedure, which subsided within a few minutes. The patients were called after 1 week. Ulceration of the lesions was noticed. This was followed by complete healing with slight scarring within 2 weeks [Figure 3].

Figure 3

Healing with slight scar

DISCUSSION

Mucoceles are fairly common conditions. Although not associated with significant morbidity, they can be the cause of discomfort. Although many other modalities of treatment of mucosal cysts exist, intralesional 88% phenol presents a simple and effective way of treating them. 88% phenol acts as a local cauterant[45] causing ablation of the cyst. The advantage is that there is no intraoperative or postoperative bleeding, there are minimal surgical defects and there is minimal scarring. No systemic complication of phenol was noted in any of our patients. Hence, intralesional injection of 88% phenol presents an easy and effective way for treatment of mucosal cysts.