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Trafalski M, Kozakiewicz M, Jurczyszyn K. Application of Fractal Dimension and Texture Analysis to Evaluate the Effectiveness of Treatment of a Venous Lake in the Oral Mucosa Using a 980 nm Diode Laser-A Preliminary Study. MATERIALS 2021; 14:ma14154140. [PMID: 34361334 PMCID: PMC8347063 DOI: 10.3390/ma14154140] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022]
Abstract
Venous lake (VL) is a common lesion resulting from the enlargement of thin-walled veins surrounded by a thick wall of fibrous tissue. Photocoagulation is becoming one of the basic methods for treating small vascular lesions. The aim of this study was an application of texture analysis (TA) and fractal dimension analysis (FDA) to evaluate VL treatment. Twenty-three VLs were included in the study. We used a 980 nm diode laser, 6 W, 100 ms pulse mode with a 50% duty cycle. The total dose of energy was in a range from 80 J to 600 J. We used the difference of intensity algorithm for FDA and microcontrast and a co-occurrence matrix for TA. A complete therapeutic effect was achieved in 83%, and in 9%, scar formation was observed after three months. No healing was observed in 4%, and there was partial healing in 4%. No differences in FD were observed between the lesions after three months and the healthy mucosa. The fractal dimension and microcontrast of a vascular lesion are mutually coupled. FDA and TA is a useful and objective method of assessing treatment effects for venous lakes. The non-contact mode of the 980 nm diode laser is an effective and safe method for treating a VL.
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Affiliation(s)
- Mateusz Trafalski
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 S. Żeromski Street, 90-549 Lodz, Poland;
| | - Kamil Jurczyszyn
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Correspondence:
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Sivolella S, Sibillin M, Lupi A, Zanette G, Giraudo C. Diode laser for the treatment of a high flow lip vascular malformation: a case report with four years follow up. Minerva Dent Oral Sci 2021; 71:248-253. [PMID: 33929135 DOI: 10.23736/s2724-6329.21.04486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND About 50% of vascular malformations are located at the head and neck region where they can usually be associated with functional and/or aesthetic limitations. Laser treatment has proven to be effective in treatment of small low-flow vascular malformations but little is known about the use of this therapy for high-flow larger arteriovenous malformations (AVMs). METHODS a congenital high-flow vascular malformation of the upper lip had to be treated because it was causing functional impairment and deformity which were affecting the quality of life. The mainstay of treatment is surgical therapy after embolization of the lesion but the treatment of high-flow lesions is difficult because of the high risk of mortality and morbidity. The lesion was then treated with transmucosal diode laser applications in multiple sessions. RESULTS The lesion progressively reduced in dimension without any sign of recurrence after multiple sessions of transmucosal diode laser applications. The clinical examination and the ultrasound scan performed four years after the last treatment demonstrated that no complications or further recurrence occurred. CONCLUSIONS multiple sessions of diode laser application can be a safe, effective and minimally invasive treatment for oral mucosa vascular malformations, even if characterized by high flow.
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Affiliation(s)
- Stefano Sivolella
- Dentistry Section, Department of Neurosciences, University of Padua, Padua, Italy
| | - Manuel Sibillin
- Dentistry Section, Department of Neurosciences, University of Padua, Padua, Italy -
| | - Amalia Lupi
- Radiology Institute, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Gastone Zanette
- Dentistry Section, Department of Neurosciences, University of Padua, Padua, Italy
| | - Chiara Giraudo
- Radiology Institute, Department of Medicine - DIMED, University of Padua, Padua, Italy
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Ramakrishnan K, Palanivel I, Narayanan V, Chandran S, Gurram P. Management of vascular malformations in the Oral and maxillofacial region: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 122:588-599. [PMID: 33400992 DOI: 10.1016/j.jormas.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose is to determine the comprehensive review and the current concepts on the management of vascular malformation and to evaluate the long term outcomes, recurrence and complication rate. METHODS This systematic review followed PRISMA guidelines and registered in PROSPERO (CRD42020173735). The PUBMED, EBSCO, SCOPUS and NDH databases were used to perform a comprehensive search of articles published up until July 2020. The database search identified 1719 articles. After an intricate review, 34 studies were estimated for eligibility. RESULTS A total of 1719 patients with mean age of 27.48 years were treated for vascular malformation in the oral and maxillofacial region. Moderate heterogeneity was observed for the outcome (P = 0.166; 95% CI:1.01-1.46, I2 = 48%). As determined by one-way ANOVA, there was no statistically significant difference between the type of diagnosis and the recurrence (F = 2.313, p = 0.092) and the complication rate (F = 2.112, p = 0.117). CONCLUSION In accordance with the available scientific literature, this review has highlighted the modalities and advancement in the management of vascular malformations. Complications and recurrence were reported in all types of management. It can be avoided by careful diagnosis, pre-operative assessment and treatment planning.
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Affiliation(s)
- Karthik Ramakrishnan
- Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM University, Tamil Nadu, 603203 Chennai, India
| | - Indu Palanivel
- Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM University, Tamil Nadu, 603203 Chennai, India
| | - Vivek Narayanan
- Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM University, Tamil Nadu, 603203 Chennai, India
| | - Saravanan Chandran
- Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM University, Tamil Nadu, 603203 Chennai, India
| | - Prashanthi Gurram
- Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College & Hospital, SRM University, Tamil Nadu, 603203 Chennai, India
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Successful Intralesional Laser Therapy for Sclerotherapy-resistant Huge Venous Malformation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3269. [PMID: 33425584 PMCID: PMC7787318 DOI: 10.1097/gox.0000000000003269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
Venous malformations (VMs) are compressible, blue-purple tumors that are present at birth, and are treated with either surgery or sclerotherapy, or a combination of both. Patients often experience recurrent hemorrhage, swelling, pain, or difficulty in daily life. Treatment of massive VMs can, therefore, be challenging. We applied intralesional laser photocoagulation (ILP) to a 19-year-old female patient with a huge VM who had shown resistance to sclerotherapy. It spanned from the dorsal area to the lateral chest. ILP is delivered directly into thick, deep lesions through a bare fiber delivery system. The effect on deep components is optimized without directly contacting the cutaneous or mucosal surfaces to minimize epithelial damage. We applied ILP to the lesion at 30 W in continuous mode (10 seconds) under ultrasound monitoring using an Nd:YAG laser of 1064-nm wavelength. In total, there have been 4 sessions of the same treatment; the lesion was treated with a combined 120 kJ of energy. Satisfactory regression of the huge VM was achieved by this ILP treatment. No significant complications (major bleeding, severe pain, post-perforation skin ulcer, and scar contraction) occurred during the treatment. ILP has been indicated for only sclerotherapy-resistant cases until now, but we suggest that it is a potentially safe and minimally-invasive resolution of VM without scarring or loss of normal shape, sensory feel, or function. ILP appears to be a safe and minimally-invasive resolution of VM. We propose that this technique could become a first-choice treatment modality for VM.
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Early tongue carcinomas (clinical stage I and II): echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up. Lasers Med Sci 2019; 35:751-758. [PMID: 31834561 DOI: 10.1007/s10103-019-02932-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 11/27/2019] [Indexed: 12/15/2022]
Abstract
The management of patients with early stage (cT1-T2) tongue squamous cell carcinoma without clinicoradiologic evidence of neck node metastasis (cN0) has been widely debated over the last 3 decades and still remains controversial. Nevertheless, the identification of patients with low-stage tumours at high-risk for occult cervical metastases is imperative before planning treatments of primary tumours, as well as that of prognostic markers which may possibly select those patients who may benefit of additional workup after surgery in view of the high metastatic potential of the primary tumour. The pre-surgical evaluation of tongue malignant primary tumour (for assessing lateral and deep margins) along with diode laser surgery (with accurate incision, bleeding-free and with reduced/absent post-surgical complications) may lead to a more conservative but equally decisive surgical treatment, also with a greater patient compliance. We studied 85 consecutive cases of cT1-T2 N0 tongue squamous cell carcinoma who had been managed by the following diagnostic/therapeutic protocol: pre-operative high definition ultrasound examination for the evaluation of size and depth, followed by three-dimensional surgical excision by diode laser (wavelength of 800 ± 10 nm, output power of 8 W in continuous wave, flexible optic fibre of 320 μm in contact mode) and detailed histological analyses of well-established prognostic parameters (tumour grade, thickness, depth, front of infiltration and surgical margins) with statistical analysis. No post-surgical photobiomodulation was performed. Overall, 58.82% of patients were stage I, 18% stage II, and the most frequent histotype was squamous cell carcinoma (97.64%). Large nests invasion pattern was observed in 64 cases, expansive pattern in 9, invasion in single cells in 12; front of invasion involved the muscle in 62 cases, vessels in 6, nerves in 15; peritumoural vascular invasion was assessed in 6 patients and perineural invasion in 15. Selective neck lymphadenectomy was performed in 9 cases, and clinically occult node metastases were detected in two cases. At follow-up, 78 patients (98.73%) were alive and free of disease, one patient experienced tumour-related death, while the remaining 6 died for non-disease-related causes. All the histological prognostic parameters were statistically significant (χ2 test; p = 0.05), thus leading to a prognostic weight classification with a three-tiered stratification. On the bases of these results, the authors maintain that the reported diagnostic/therapeutic protocol, including the pre-operative echo-guided three-dimensional evaluation, the following diode laser mini-invasive surgery for tumour excision and the histological examination along with the proposed three-tiered stratification of histological prognostic parameters may allow proper management of clinical stage I and II early tongue carcinomas.
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Costa Mendes L, Laurencin-Dalicieux S, Paul C, Bulai Livideanu C, Cousty S. Vascular Nd:YAG laser: a therapeutic alternative for large venous lakes of the oral mucosa. J Eur Acad Dermatol Venereol 2019; 34:e164-e165. [PMID: 31774577 DOI: 10.1111/jdv.16110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L Costa Mendes
- Oral Mucosal Pathology Consultation, Department of Dental Medicine, Toulouse University Hospital, Paul Sabatier University, Toulouse, France
| | - S Laurencin-Dalicieux
- Oral Mucosal Pathology Consultation, Department of Dental Medicine, Toulouse University Hospital, Paul Sabatier University, Toulouse, France
| | - C Paul
- Department of Dermatology, Toulouse University Hospital, Paul Sabatier University, Toulouse, France
| | - C Bulai Livideanu
- Department of Dermatology, Toulouse University Hospital, Paul Sabatier University, Toulouse, France
| | - S Cousty
- Oral Mucosal Pathology Consultation, Department of Dental Medicine, Toulouse University Hospital, Paul Sabatier University, Toulouse, France
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Limongelli L, Tempesta A, De Caro A, Maiorano E, Angelelli G, Capodiferro S, Favia G. Diode Laser Photocoagulation of Intraoral and Perioral Venous Malformations After Tridimensional Staging by High Definition Ultrasonography. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:722-728. [PMID: 31560255 DOI: 10.1089/photob.2019.4635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To determine optimal settings for use of diode lasers to treat vascular malformations in the head and neck. Background: Diode lasers are generally accepted as effective tools to treat vascular malformations in the head and neck, yet there are no standardized treatment protocols for this treatment approach. Settings for these lasers, in addition to laser type and size and lesion depth are important variables for designing appropriate treatments for vascular malformations. Materials and methods: Vascular venous malformations (VeMs) were classified into five groups according to high-definition ultrasound measurements of superficial dimensions (<1, 1-3, and >3 cm) and lesion extension depth (≤5, and >5 mm). Using a 800 ± 10 nm diode laser for surgical procedures, we treated lesions by two different approaches: trans-mucous/cutaneous photocoagulation (8 and 12 W pulsed wave for cutaneous and mucosal lesions, respectively) and intralesional photocoagulation using a laser set to 13 W in the pulsed wave modality to treat both cutaneous and mucosal lesions. Results: We treated 158 vascular VeMs. According to preoperative staging, there were 52 lesions in Group A (superficial dimension <1 cm), 28 in Group B1 (superficial dimension from 1 to 3 cm, extension depth ≤5 mm), 16 in Group B2 (superficial dimension from 1 to 3 cm, extension depth >5 mm), 42 in Group C1 (superficial dimension >3 cm, extension depth ≤5 mm), and 12 in Group C2 (superficial dimension >3 cm, extension depth >5 mm). All Group A lesions showed complete healing after a single laser treatment, whereas 7%, 10%, 12%, and 16% of lesions classified in Groups B1, B2, C1, and C2, respectively, required further treatments. Conclusions: The laser settings defined in this study were associated with a reduced number of laser applications needed for effective treatment of vascular VeMs. Moreover, the cooling of irradiated tissues, together with prolonged application of a topical regenerative gel, provided good treatment acceptability, reduced the number of postoperative complications, and promoted faster healing of covering tissues.
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Affiliation(s)
- Luisa Limongelli
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Alessio De Caro
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Giuseppe Angelelli
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
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Efficacy of Photocoagulation of Vascular Malformations in the Oral Mucosa Using Nd. J Craniofac Surg 2018; 29:e614-e617. [DOI: 10.1097/scs.0000000000004676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Miyazaki H, Ohshiro T, Romeo U, Noguchi T, Maruoka Y, Gaimari G, Tomov G, Wada Y, Tanaka K, Ohshiro T, Asamura S. Retrospective Study on Laser Treatment of Oral Vascular Lesions Using the "Leopard Technique": The Multiple Spot Irradiation Technique with a Single-Pulsed Wave. Photomed Laser Surg 2018; 36:320-325. [PMID: 29717920 DOI: 10.1089/pho.2017.4410] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to retrospectively evaluate the efficacy and safety of laser treatment of oral vascular lesions using the multiple spot irradiation technique with a single-pulsed wave. BACKGROUND DATA In laser therapy for vascular lesions, heat accumulation induced by excessive irradiation can cause adverse events postoperatively, including ulcer formation, resultant scarring, and severe pain. To prevent heat accumulation and side effects, we have applied a multiple pulsed spot irradiation technique, the so-called "leopard technique" (LT) to oral vascular lesions. This approach was originally proposed for laser treatment of nevi. It can avoid thermal concentration at the same spot and spare the epithelium, which promotes smooth healing. The goal of the study was to evaluate this procedure and treatment outcomes. PATIENTS AND METHODS The subjects were 46 patients with 47 oral vascular lesions treated with the LT using a Nd:YAG laser (1064 nm), including 24 thick lesions treated using a combination of the LT and intralesional photocoagulation. RESULTS All treatment outcomes were satisfactory without serious complications such as deep ulcer formation, scarring, bleeding, or severe swelling. CONCLUSIONS Laser therapy with the LT is a promising less-invasive treatment for oral vascular lesions.
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Affiliation(s)
- Hidetaka Miyazaki
- 1 Department of Plastic and Reconstructive Surgery, Wakayama Medical University , Wakayama, Japan
| | - Takafumi Ohshiro
- 2 Plastic and Reconstructive Surgery, Ohshiro Clinic , Tokyo, Japan
| | - Umberto Romeo
- 3 Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome , Rome, Italy
| | - Tadahide Noguchi
- 4 Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University , Tochigi, Japan
| | - Yutaka Maruoka
- 5 Division of Dentistry/Oral and Maxillofacial Surgery, National Center for Global Health and Medicine , Tokyo, Japan
| | - Gianfranco Gaimari
- 3 Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome , Rome, Italy
| | - Georgi Tomov
- 6 Department of Oral Pathology, Faculty of Dental Medicine, Medical University of Plovdiv , Plovdiv, Bulgaria
| | - Yoshitaka Wada
- 1 Department of Plastic and Reconstructive Surgery, Wakayama Medical University , Wakayama, Japan
| | - Kae Tanaka
- 7 Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Toshio Ohshiro
- 2 Plastic and Reconstructive Surgery, Ohshiro Clinic , Tokyo, Japan
| | - Shinichi Asamura
- 1 Department of Plastic and Reconstructive Surgery, Wakayama Medical University , Wakayama, Japan
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Bacci C, Sacchetto L, Zanette G, Sivolella S. Diode laser to treat small oral vascular malformations: A prospective case series study. Lasers Surg Med 2017; 50:111-116. [PMID: 28906568 DOI: 10.1002/lsm.22737] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The current work examined a consecutive series of patients presenting vascular malformations (VMs) and venous lakes (VLs) of the lip and oral mucosa who were treated with transmucosal diode laser applications and assessed over a 1 year period. STUDY DESIGN AND METHODS Fifty-nine patients (31 males and 28 females) presenting low-flow VMs or VLs of the oral cavity were treated transmucosally using a diode laser (with an 830 nm operating wavelength and 1.6 W output power) with a 320 µm diameter flexible fiber. All the lesions were assessed 7 days, 30 days, and 1 year after the laser treatment, and the lesion reduction percentage was scored on a one to five scale. The patients were also asked to assess their pain perception daily during the 7 days following the treatment using a visual analog scale (VAS). RESULTS There were no procedure-related intra- or post-operative complications; only modest pain intensity was reported. Thirty days after the treatment, lesion reduction was described as excellent or good in 52 cases; it was fair or poor in 7. Six patients (F:M ratio 2:4) required a second diode laser application. At the 1 year follow-up, volume reduction was complete in 48 out of 59 patients; there were five recurrences (F:M ratio 3:2). No relevant gender-related differences were noted. CONCLUSION The use of diode laser application to treat small oral VMs and VLs was associated to shorter operating times and fewer postoperative complications with respect to the scapel surgery approach. More than one session may nevertheless be required if the anomaly is larger than 10 mm. Lasers Surg. Med. 50:111-116, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Christian Bacci
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
| | - Luca Sacchetto
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
| | - Gastone Zanette
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
| | - Stefano Sivolella
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
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Bastos JT, Balassiano LKDA, Mariano da Rocha CR, Freitas BMPD, Bravo LG, Bravo BSF. Treatment of vascular lesions located in the lip and in the oral cavity with Nd:YAG laser. J COSMET LASER THER 2017; 19:256-258. [PMID: 28388305 DOI: 10.1080/14764172.2017.1314503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Vascular lesions such as hemangiomas can be found in the oral cavity. Some therapeutic modalities can be used in the treatment of these lesions and Nd:YAG 1064 nm long pulse laser shows good results with easy application, fewer complications and satisfactory results. This study describes the technique and outcome of a case of hemangioma located on the tongue treated with Nd:YAG laser.
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Abstract
To analyze the clinical characteristics and treatment outcomes of vascular anomalies, and determine which therapy is safe and effective. The data of vascular anomalies pediatric patients who arrived at Beijing children's Hospital from January 2001 to December 2014 were analyzed retrospectively, including the influence of gender, age, clinical manifestation, diagnosis, treatment options, and outcomes. As to infantile hemangiomas, the outcomes of different treatments and their adverse reactions were compared. As to spider angioma and cutaneous capillary malformation, the treatment effect of 595 nm pulsed dye laser (PDL) is analyzed. A total number of 6459 cases of vascular anomalies were reclassified according to the 2014 ISSVA classification system. Among them, the gender ratio is 1:1.69, head-and-neck involved is 53.3%, the onset age within the first month is 72.4%, the age of initial encounter that younger than 6 months is 60.1%. The most common anomalies were infantile hemangiomas (42.6%), congenital hemangiomas (14.1%), and capillary malformations (29.9%). In treating infantile hemangiomas, laser shows the lowest adverse reactions rate significantly. Propranolol shows a higher improvement rate than laser, glucocorticoids, glucocorticoids plus laser, and shows no significant difference with propranolol plus laser both in improvement rate and adverse reactions rate. The total improvement rate of 595 nm PDL is 89.8% in treating spider angioma and 46.7% in treating cutaneous capillary malformation. The improvement rate and excellent rate of laser in treating cutaneous capillary malformation are growing synchronously by increasing the treatment times, and shows no significant difference among different parts of lesion that located in a body. Vascular anomalies possess a female predominance, and are mostly occurred in faces. Definite diagnosis is very important before treatment. In treating infantile hemangioma, propranolol is recommended as the first-line agent, and systemic use glucocorticoids should be considered when associated with serious complications. The 595 nm PDL is effective in managing superficial vascular malformations in childhood, and could attempt to increase the treatment times to improve the outcomes.
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Affiliation(s)
- Bin Yang
- From Department of Dermatology, Beijing Children's Hospital, Capital Medical University, Beijing, China (BY, LL, L-xZ, Y-jS, LM)
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