Laser treatment of 13 benign oral vascular lesions by three different surgical techniques

U Romeo,C Russo,Aj Espana,G Palaia,A Del Vecchio,G Gaimari,J Arnabat-Dominguez

doi:10.4317/medoral.18156

Abstract

Objectives: Benign Oral Vascular Lesions (BOVLs) are a group of vascular diseases characterized by congenital, inflammatory or neoplastic vascular dilations clinically evidenced as more or less wide masses of commonly dark bluish color. If traumatized BOVLs are characterized by a great risk of hemorrhage and their treatment usually requires great caution to prevent massive bleeding. In the last decades lasers have dramatically changed the way of treatment of BOVLs permitting the application of even peculiar techniques that gave interesting advantages in their management reducing hemorrhage risks. The aim of this study was to evaluate the capabilities and disadvantages of three laser assisted techniques in the management of BOVLs. Study design: In this study 13 BOVLs were treated by three different laser techniques: the traditional excisional biopsy (EB), and two less invasive techniques, the transmucosal thermocoagulation (TMT) and the intralesional photocoagulation (ILP). Two different laser devices were adopted in the study: a KTP laser (DEKA, Florence, Italy, 532nm) and a GaAlAs laser (Laser Innovation, Castelgandolfo, Italy, 808nm) selected since their great effectiveness on hemoglobin. Results: In each case, lasers permitted safe treatments of BOVLs without hemorrhages, both during the intervention and in the post-operative period. The minimally invasive techniques (TMT and ILP) permitted even the safe resolution of big lesions without tissue loss. Conclusions: Laser devices confirm to be the gold standard in BOVLs treatment, permitting even the introduction of minimal invasive surgery principles and reducing the risks of hemorrhage typical of these neoplasms. As usual in laser surgery, it is necessary a clear knowledge of the devices and of the laser-tissue interaction to optimize the results reducing risks and disadvantages. Key words:Oral vascular diseases, laser, photocoagulation.

Highlights

The Benign Oral Vascular Lesions (BOVLs), are a group of common benign oral neoplasms including haemangiomas and vascular malformations
Objectives: Benign Oral Vascular Lesions (BOVLs) are a group of vascular diseases characterized by congenital, inflammatory or neoplastic vascular dilations clinically evidenced as more or less wide masses of commonly dark bluish color
Study design: In this study 13 BOVLs were treated by three different laser techniques: the traditional excisional biopsy (EB), and two less invasive techniques, the transmucosal thermocoagulation (TMT) and the intralesional photocoagulation (ILP)

Summary

Introduction

The Benign Oral Vascular Lesions (BOVLs), are a group of common benign oral neoplasms including haemangiomas and vascular malformations. The real position of the fiber can be perceived by the transillumination produced by laser This treatment is useful in deep and large lesions as vascular malformations of the tongue and big haemangiomas. In these cases the KTP laser is the most effective device because of its high specificity for the hemoglobin present in each of these lesions [5,6,7,8]. ILP therapy allows safe treatment of bulky vascular lesions that cannot be treated by EB because of the danger of massive bleeding or for the treatment of lesions located in aesthetic areas that could create large unaesthetic scarring [5] if removed by traditional methods. The aim of the study is to evaluate advantages and disadvantages of these techniques and compare their ways of action

Objectives

Methods

Conclusion