J.C.Maroon, et al: Cryosurgery re-visited for the removal and destruction of brain, spinal and orbital tumors. Neurological Research 14: 294-302, 1992.

Advances in neuroimaging and cryosurgical techniques have prompted us to re-evaluate the potential of cryosurgical techniques for the removal and the destruction of various neoplasms. We have used cryosurgical instrumentation to remove tumors in the brain, spine and orbit in 71 patients without complications. Cryosurgery was used to facilitate removal and extraction in 64 and to destroy residual neoplasms when removal was incomplete in 7. lntraoperative real time ultrasonic imaging permitted precise delimitation of tumors from surrounding tissues and allowed monitoring during the production of cryosurgical lesions thus permitting heretofore unavailable visualization of the production of cryogenic lesions in the central nervous system. New cryosurgical instrumentation was used to produce lesions up to three times larger than similar sized probes previously available. Our results reconfirm that cryosurgery facilitates the removal of tumors in the brain, spinal cord and orbit, reduces blood loss in vascular tumors, and is effective in ablating residual neoplasms involving the superior saggital sinus, torcula and parasaggital areas. A Doppler flowmeter proved useful for monitoring saggital sinus blood flow during the production of cryosurgical ablation of residual tumor attached to the walls of the saggital sinus. Recent advances in ultrasonic and neuroimaging coupled with stereotactic techniques and improvements in cryosurgical instrumentation may prove useful in the future percutaneous destruction of selective intracranial neoplasms. [Neurol Res 1992; 14: 294-302]