OP165: Prophylactic laser surgery of oral cavity’s precancerous lesions: Our experience

Abstract

Purpose The importance of primary prevention is nowaday accepted as the most useful way to avoid oral cavity precancerosis transformation in malignant conditions. Prevention includes clinical observation, stopping smoking, and removing risk factors. Furthermore the introduction of laser CO2 surgery allows to manage such lesions through evaporation, without any scar retractions and consequent chewing discomfort, thanks to the haemostatic effect and the preserving of muscular layer. The reduction of surgical timing and low relapse of disease make this procedure to be considered safe. Materials and methods Authors show their experience in a series of 93 patients observed (25 female and 36 males, mean age 55 years) from 2002 to 2012. 61 of them underwent to CO2 laser evaporation to remove a total of 157 heterogeneous lesions of oral cavity. Definitive histologic examinations were performed. The procedure included the resection as an excisional biopsy without involving the deep muscular layer. Results In 37% lesions involved the tongue. In 63% pre cancerous lesion were found out and 7% of cases showed squamous cell carcinoma. In a 7 years period of follow up a 4,3% of pathology relapse has been observed. 93% cases have shown a good wound healing, combinig diclofenac mouth washes and ialuronic acid therapy via aerosol were carried out, during the post operative period to improve wound closure. Conclusion Sterilization due to thermic effect permits a better pain control, without any antibiotic in the post operative period, edema reduction. Despite of high temperature laser allows to conserve tissue layer and the margin resection. According to literature our experience could confirm the importance of the laser surgical treatment of all the suspicious lesions of the oral cavity. The histologic diagnosis of precancerosis prevents malignant transformation and so demolitive and reconstructive surgery that may interfere with the patients quality of life.