Cryosurgery for head and neck tumors

Abstract

As with any type of treatment, there are some complications from cryosurgery of head and neck tumors, in particular, a permanent loss of pigment at the frozen site. Hyperpigmentation is transient, as are hypertrophic scars. Keloids have never been reported following cryosurgery, even in keloid producers. Local edema, particularly around the orbit, is an aftereffect of cryosurgery, particularly if the frozen tumor is situated on the forehead, temple, or upper aspects of the nose. Neuritis following cryosurgery is extremely rare: in most cases normal function and sensation return. Cryosurgery should be avoided in patients with cryoglobulinemia, cryofibrinogenemia, autoimmune disease, and collagen disease. I avoid freezing carcinomas near the vermillion border of the upper lip because of the occasional upturn of the mucous membrane of the lip. Cancers situated upon the scalp and basal cell carcinomas that show the histological features of the sclerosing, or morphea type, have a higher recurrence rate following cryosurgery. Neoplasia at the nasolabial fold and ala nasi have higher recurrence rat from cryosurgery than other sites. In the past 14 years the author has treated 2156 patients with a combined total of 3246 head and neck carcinomas. Statistical breakdown is as follows: basal cell carcinomas, 2954 (91.1%); epidermoid carcinomas, 160 (4.9%); basosquamous cell carcinomas, 75 (2.3%); Bowen's disease (carcinoa in situ). 41 (1.2%); lentigo maligna, 13 (0.4%); and Kaposi hemorrhagic sarcomas, 3 (0.1%). At this writing, 90 recurrences have been recorded, representing a cure rate of 95.9% in the 2156 patients, or a 97.3% cure rate if one considers the combined total of 3246 head and neck tumors subjected to cryosurgery.