Abstract
Introduction: The appearance of vascular anomalies in the orofacial area is a common condition, which represents about 50% of these malformations. Traditional treatment approach, such as surgery and chemical sclerosis has been given way to a few less-invasive options, as the use of the 810nm diode laser to induce the sclerosis of the venous malformation by intralesional photocoagulation. Objectives: The objective of this study was to determine the efficacy of the diode laser in the intralesional treatment of the orofacial venous malformations (OFVM), describing the recommended surgical approach, as well as to report the main associated complications. Patients and Methods: 10 cases of OFVM, diagnosed and treated at the Oral Surgery Department of the Dental Clinic of the University of Barcelona, between January, 2009 and April, 2011. Every case was treated under local anesthesia, performing at least one intralesional session of diode laser, applying an 1W active optic fiber, in continuous mode, inserted into the interior of the lesion through an intramuscular needle, from the deepest portion to the surface of the lesion. Postoperative medication was indicated and follow-up visits were perform during a period of at least 6 months. Results: Of a total of 10 cases of OFVM, mean age of 25.4 years, 8 required just a single session with intralesional laser diode, before the clinical verification of a total reduction of size of the lesion. In 2 of these cases, were needed at least 2 sessions of intralesional photocoagulation to reach a satisfactory cosmetic result. No complications of any kind occurred. After a follow-up period of at least 6 months only a case of recurrence was described. Discussion and Conclusions: The advantages associated to the use of non-invasive techniques in the treatment of OVM, along with the success rate and low number of relapses, shows the use of the diode laser as a therapy to be considered in the treatment of these lesions. A higher case mix would be essential for definitive conclusions. Key words:Diode laser, hemangioma, orofacial venous malformation.
Highlights
The appearance of vascular anomalies in the orofacial area is a common condition, which represents about 50% of these malformations
The first group includes those tumors associated with a process of endothelial cell proliferation, which appears in childhood, with proliferative changes, followed by an involutional process of unknown etiology, called hemangiomas, and a second group consisting of those vascular malformations (VM) that appears as a result of the altered development and formation of blood vessels, present at the birth, normal endothelial mitotic activity, which grows with the individual and with no presence of an involutional process (2)
Follow-up visits are performed at 7, 30, 180 and 365 days. 80% of the treated orofacial venous malformations (OFVM) required a single session of intralesional endoluminal treatment to completely remove the lesion, this was confirmed during the followup visits
Summary
The appearance of vascular anomalies in the orofacial area is a common condition, which represents about 50% of these malformations Traditional treatment approach, such as surgery and chemical sclerosis has been given way to a few less-invasive options, as the use of the 810nm diode laser to induce the sclerosis of the venous malformation by intralesional photocoagulation. Photocoagulation using laser Nd: YAG as a method of treatment of vascular lesions is based on the high capacity of absorption of light by hemoglobin, which in conjunction with the heat released by the absorption of laser light during the penetration of the tissues, produces a selective coagulation of the affected blood vessels. The objectives of this study are, using the report of cases treated in our department, to determine the efficacy of diode laser (λ 810nm) in the intralesional treatment of orofacial vascular malformations (OFVM), describe the surgical technique used, and report major complications
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