[Light microscopic findings of cryosurgically treated tonsils following chronic tonsillitis (author's transl)]

The light microscopic findings of tonsillar tissues from nineteen patients (aged 13-51) with the clinical diagnosis of chronic tonsillitis are described at sequential intervals following cryosurgical treatment. The Cooper instrument was used, containing liquid nitrogen and capacity limited cryoprobes as well as probes of a flow system. Two consecutive freeze-thaw cycles were used during a single session in each patient, with freezing time varied from 30 seconds to three minutes. In addition to primary cryosurgical tissue changes such as hyperemia, edema, inflammation, necrosis, fibroplasia with capillary increase, collagenous fibrosis and reepithelialisation, the following could be found: 1. A different cryosensibility of the cells and fibers within the cryolesion: The tonsillar septae are much more resistant to cold than the lymphoid tissue. Of this latter tissue, the reticulin cells and the lymphoblasts are more sensitive to the cold changes than are the matured lymphocytes. In the epithelium the stratum basale is as sensitive to cold as the lymphoreticulum. The outer epithelial cells are more resistant to cold than the basal cells. 2. A quick proliferation in the periphery of the cryolesion is seen in the form of an acanthosis and papillomatosis which begins before slough of necrotic debris occurs. 3. Sharp demarcation and protracted sloughing of necrotic epithelium from the free tonsillar surface or crypts and lymphoid tissue can be seen. 4. Reepithelialization can first be seen following slough of the cryonecrosis twenty days following cryosurgery, after which total reepithelialization occurs.