Bisherige Ergebnisse der Stickstoff-Kryotherapie bei Lidbasaliomen

Abstract

By means of long-term follow-ups of large numbers of patients it has been established that nitrogen cryotherapy for lid basaliomas produces very good results with regard to the cure rate, as well as having considerable advantages over other treatment methods. In contrast to other authors we did not employ the spray method, but a very high-performance nitrogen cryo unit with a closed probe. Experimental measurements showed that this unit is capable of generating at least the same temperatures as with the spray method. The cryoapplication technique is described. The cure rate and causes of recurrence in the first series in the total of 84 patients treated from 1979 to 1983 were evaluated by long-term follow-up. If cryobiological principles are observed and the recommended application technique is adhered to, the same cure rate can be achieved as with the spray method and other forms of treatment. There are considerable functional and cosmetic advantages, also as regards the patency of the lacrimal ducts.

A reappraisal of cryosurgery for eyelid basal cell carcinomas

“…The histopathological type of the tumours (basal cell carcinoma, squamous cell carcinoma, or morphoea like) had no significant influence on the recurrence rate, according to our former analysis. 28 Cryosurgeons should always keep in mind that the area of ice formation is much larger than that of tumour destruction (thermorecorder recommended). They should acquire basic knowledge of cryobiology, and pass a training programme as recommended in the guidelines of the dermatologists in the United States.…”

Cryotherapy for malignancies of the eyelid

“…Results have been published since 1960s on liquid nitrogen cryotherapy of basal cell carcinoma of the eyelid; in the past few years, several results of longterm follow-up studies have been published, according to which the recurrence rate of basal cell carcinoma is no greater after cryotherapy than after any other form of therapy (Kuflik 1978, Biro & Price 1979, Fraunfelder et al 1980, Beard 1981, Biro et al 1982, Fraunfelder et al 1984, Gunnarson & Hersle 1985, Kuflik 1985, Buschmann et al 1986, Prskavec 1986). The recovery rates after over five years of follow-up in materials of 30 to 164 cases vary from 82 to 97 percent, depending on the size and histological type of the tumour and on whether the tumour was primary or a recurrence (Fraunfelder et al 1984, Kuflik 1985, Buschmann et a1 1986, Prskavec 1986).…”

“…In between, the tissue is allowed to thaw slowly. Nowadays it is recommended that the freezing process be performed three times, especially if the tumour is a basal cell carcinoma recurrence or a sclerosing type tumour (Biro et al 1982, Kuflik 1985, Buschmann et al 1986).…”

“…Also, the capillary damage in the freezing process and the reduction of blood circulation achieved by the vasoconstrictor enhances the destruction of cancer cells. Normal cells have a better tolerance of freezing and thawing, so regeneration the treated skin is possible (Beard 1981, Buschmann et al 1986, Prskavec 1986).…”