Cryosurgery in the treatment of head and neck neoplasia

Abstract

709pressure produced as a result of rupture of the aneurysm into the tight fascia1 compartment of the psoas and iliacus muscles. The cause of the sciatic palsy was attributed to direct pressure of a common iliac artery aneurysm impinging on the nerve trunks arising from L.V.4, L.V.5, S.V.1, and S.V.2.It is interesting to speculate on the mechanism of the lateral popliteal palsy recorded in our second case. It seems unlikely that direct pressure on the nerve trunks in the pelvis can be held responsible since the medial popliteal component of the sciatic nerve was not involved. Ischaemic neuropathy is rare since nerves receive a blood-supply from several anastomosing vessels. However, the sciatic nerve is supplied by a named vessel, the arteria comitans nervi ischiadici. It is conceivable that sudden occlusion of this vessel by embolism or thrombosis might result in ischaemic damage of vulnerable nerve-fibres, particularly in a limb already the site of extensive peripheral vascular disease. Although it is possible that the lateral popliteal palsy in our second case arose from some other cause, its development in a limb with extensive peripheral vascular disease shortly before the rupture of an abdominal aortic aneurysm makes it very likely that the neurological signs were related to the arterial disease. It is tempting to suggest that the aneurysm produced the peripheral nerve lesion either via ischaemia or pressure and that the consequent foot-drop caused the fall which precipitated aneurysmal rupture.

Practical cryosurgery—an introduction for small‐animal Clinicians*

“…Useful applications of freezing have been reported in ear, nose and throat surgery, including the management of malignancies of the pharynx and larynx (Holden & McKelvie, 1972). Cryotonsillectomy has been satisfactorily performed by Hill (1968).…”

Low Skin Temperatures Produced by New Skin Refrigerants

“…The critical determinants of the extent of cell injury in cryotherapy are the duration of freezing, the rate of freezing, the rate of thawing, and most importantly, the coldest temperature achieved 5 . Many studies have shown that temperatures of – 20°C may be lethal for cells 6–9 . Animal tissue begins to freeze at – 2.2°C 10 .…”

Five-Year Survival Following Cryosurgery for Oral Cancer

“…Alternative methods of treatment were described to the patients as part of the informed consent routine, but rarely was the suggested plan of treatment refused. In selection of patients with Accepted for publication May 5,1976. From the Department of Surgery, Veterans Administration Hospital and the State University of New York at Buffalo School of Medicine.…”