Laser therapy of vascular lesions

532-nm potassium titanyl-phosphate laser versus 595-nm pulsed dye laser for port-wine birthmarks: A prospective, randomized, split-side study

BACKGROUND

Pulsed dye lasers (PDL) are currently the first-line treatment of port-wine birthmarks (PWB). Due to high maintenance costs and instable technology, alternative methods are needed.

OBJECTIVES

To compare clinical outcomes of a variable-sequenced, long-pulsed 532-nm potassium titanyl-phosphate (KTP) laser and PDL on treating PWB.

METHODS

A prospective, randomized, split-side study. Patients were treated with a KTP laser and PDL with 1 to 5 sessions at intervals of 6-8 weeks. A follow-up visit was scheduled 6 weeks post-treatment. Efficacy was evaluated through colorimetric analysis, area reduction measurements and clinical evaluations by two blinded investigators based on photo documentation. Subjects provided rating of pain intensity during treatment, post-treatment reactions and satisfaction. Safety was measured by adverse events. Maintenance issues of the laser systems were documented.

RESULTS

A total of 35 patients (mean age 42.1 years) were enrolled. 63% were female. Patients received 2.4 (SD 1.4; 1-5) treatment sessions. Colorimetric analysis indicated a comparable clearance effect in PWB of both KTP laser and PDL. Independent investigators rated clinical appearance to be significantly improved compared to baseline. No significant difference was observed between both laser systems. Regarding post-treatment reactions, the KTP laser caused less swelling, purpura and crusts. 96% would recommend both treatment modalities. Patients were satisfied with both laser systems. During the study, PDL systems malfunctioned for 6.6 months in total. For the KTP laser, we did not observe any system failures.

CONCLUSION

Our data indicate that the KTP laser of the latest generation with large-spot sizes, subpulse technology and cryogen cooling has a comparable efficacy to the PDL in treating PWB. In addition, KTP laser is associated with greater tolerability, fewer technical failures and lower repair costs. Further prospective studies are required to determine the true effectiveness of the KTP laser in PWB treatment. This study was preregistered in Clinicaltrials.gov (NCT05771298).

Laser Forced Dehydration of Benign Vascular Lesions of the Oral Cavity: A Valid Alternative to Surgical Techniques

Background and Objectives: Low-flow vascular lesions are commonly encountered in the oral cavity and may require removal due to aesthetic concerns, repeated bleeding or a cluttering sensation. Laser devices represent an excellent aid due to their affinity with blood and to their biostimulating properties and have been substituting traditional excision in selected cases. Materials and Methods: In this study, 30 patients presenting with low-flow oral vascular lesions were included. The lesions were clinically evaluated as follows: lesion's site, reason for treatment, lesion's dimensions, confirmation of positive diascopy via compression with a glass slide and photograph. The lesions were treated with laser forced dehydration (LFD) and then followed-up after 3 weeks, 6 months and 1 year. The laser source was a K-Laser Blu Derma (Eltech, K-Laser S.r.l., Via Castagnole, 20/H, Treviso, Italy). In the case of incomplete healing, a further protocol was performed at the three-week follow-up, and a further follow-up was scheduled for three weeks after. The following aspects were evaluated at each appointment: pain, using a Numeric Rating Scale (NRS) from 0 to 10 (0 = no pain, 10 = worst pain ever); the need to take painkillers (day of intervention and during follow-up); bleeding (yes/no); scar formation. Results: Complete regression was obtained in all patients, with no side effects. Only one patient required a second LFD protocol. NRS was 0 for all patients for the whole duration of the follow-up. None of the patients took painkillers on the day of the intervention and during the follow-up. One patient declared slight bleeding the day of the intervention, which she easily managed at home. One patient showed a small non-retracting and non-painful scar at the three-week follow-up. No recurrences were found after six months and one year. Conclusions: LFD targets endogenous chromophores, minimizing damage to adjacent tissue and limiting side effects. LFD is effective and could be considered a conservative alternative to traditional excision in low-flow lesions.

Lasers and Nonsurgical Modalities

Head and neck vascular pathology is routinely encountered by the maxillofacial surgeon. Although these anomalies have been traditionally managed by surgical means, adjunctive therapies have been popularized in recent years. The use of laser therapy has gained attention for its ability to better access and to provide more predictable outcomes in the highly intricate and vascular areas of the head and neck. Laser therapy allows for the selective targeting of diseased tissue while maintaining the integrity of surrounding healthy tissue.

High speed photo-mediated ultrasound therapy integrated with OCTA

Photo-mediated Ultrasound Therapy (PUT), as a new anti-vascular technique, can promote cavitation activity to selectively destruct blood vessels with a significantly lower amount of energy when compared to energy level required by other laser and ultrasound treatment therapies individually. Here, we report the development of a high speed PUT system based on a 50-kHz pulsed laser to achieve faster treatment, decreasing the treatment time by a factor of 20. Furthermore, we integrated it with optical coherence tomography angiography (OCTA) for real time monitoring. The feasibility of the proposed OCTA-guided PUT was validated through in vivo rabbit experiments. The addition of OCTA to PUT allows for quantitative prescreening and real time monitoring of treatment response, thereby enabling implementation of individualized treatment strategies.

Theoretical and in vivo experimental investigation of laser hyperthermia for vascular dermatology mediated by liposome@Au core-shell nanoparticles

The 1064 nm Nd:YAG laser shows a good prospect for the treatment of port-wine stain (PWS), but it is necessary to enhance the blood absorption to laser energy by exogenous chromophore. Owing to the conjunction effect of local surface plasmon resonance (LSPR) by gold nanoparticle and drug delivery as well as lumen blockage abilities by liposome, liposome@Au core-shell nanoparticles are used as exogenous chromophore, and the efficiency of photothermal therapy is studied systematically. In this work, theoretical simulations were conducted to investigate the electric field and solid heat conduction of liposome@Au core-shell nanoparticles with various size and particles distance, aiming to achieve maximum photothermal conversion efficiency during the laser irradiation. Thereafter, liposome@Au core-shell nanoparticles with optimal size and structure were prepared, and in vivo experiments were conducted to evaluate the thermal damage of blood vessels enhanced by liposome@Au core-shell nanoparticles. Theoretical results imply that maximum temperature rise (167 K) is obtained when radius is 45 nm and shell thickness is 5 nm with distance of 4 nm. Liposome@Au core-shell nanoparticles were prepared with diameter of 101 nm and shell thickness of 5 nm according to the finite element simulation of electric field and solid heat conduction. When the molar ratio of chloroauric acid to phospholipid is 2.25, the LSPR absorption peak is about 981 nm, which is close to the wavelength of Nd:YAG laser. In vivo experiments show that injecting liposome@Au core-shell nanoparticles into the blood vessels can effectively reduce the number of laser pulses and the corresponding energy density required for obvious vasoconstriction.

Effectiveness and Safety of Treatment with Neodymium:YAG Laser 1064 nm in Patients with Classic and Epidemic Kaposi Sarcoma

Kaposi’s sarcoma (KS) is a vascular neoplasm Herpes Virus 8 (HHV8), which can affect the skin, mucous membranes and viscera. There is currently no standard treatment for KS; this study evaluated the efficacy and safety of Neodymium:YAG (Nd:YAG) laser 1064 nm treatment in patients with classic and HIV-associated KS. 15 patients with classic KS (group A) and 15 with epidemic KS (group B), with exclusively cutaneous localization, were treated with Nd:YAG laser 1064 nm. Four treatment sessions were performed at 4 weeks intervals. 24/30 (80%) of treated patients underwent clinical improvement. Better results have been obtained in HIV-positive patients, especially in terms of reduced lesion size and the flattening of elevated lesions. The 1064 nm Nd:YAG laser is effective and safe in the treatment of classic and epidemic KS, especially in patients with symptomatic, slow-progressing local disease, where other treatment options may be inappropriate.

Wavelength optimization for the laser treatment of port wine stains

Based on the well-known principle of selective photothermolysis, laser has been a promising way for the treatment of port wine stains (PWSs). The laser wavelengths used for PWS's clinical treatment include but are not limited to pulsed dye laser (PDL) in 585-600 nm, long-pulse 755-nm alexandrite, and 1064-nm Nd:YAG lasers. The objective of this study was to investigate the optimal wavelength for PWS's laser treatment. A two-scale mathematic model was constructed to simultaneously quantify macroscale laser energy attenuation in two-layered bulk skin and microscale local energy absorption on target blood vessels within Krogh unit. The effects of morphological parameters, including epidermal melanin content, epidermal thickness, dermal blood content, blood vessel depth, and diameter on laser energy deposition within target blood vessels, were investigated from the visible to near-infrared bands (500-1100 nm). The energy deposition ratio of target blood vessel to epidermal surface was proposed to determine the optimal laser wavelength for PWS with different skin morphological parameters. The bioheat transfer modeling and animal experiment are also conducted to prove our wavelength optimization. The optimal wavelengths for lightly pigmented skin with small and shallow target blood vessels are 580-610 nm in the visible band. This wavelength coincides with commercially used PDL. The optimal wavelength shifts to 940 nm as the epidermal pigmentation increases or the size and blood vessel depth increases. The optimal wavelength changes to 1005 nm as the epidermal pigmentation or the size and burying depth of target blood vessel further increases. Nine hundred forty nanometers can be selected as a general wavelength in PWS treatment to meet the need in most widely morphological structure. Lasers with wavelengths in the 580-610, 940, and 1005 nm regions are effective for treating PWS because of their high optical selectivity in blood over the epidermis.

Induktion einer strickleiterartigen Narbe an der Wange einer 28-jährigen Frau nach Laserung eines Naevus araneus mittels KTP-Laser

Die 28-jährige Patientin stellte sich zur Behandlung einer kosmetisch störenden Gefäßläsion an der Wange vor. Es wurde eine Lasertherapie vorgeschlagen und vereinbart. Es entstanden unmittelbar nach der Laserbehandlung Schmerzen und eine Rötung; später eine entstellende Narbe.

Die Gutachter der Gutachterkommission bei der Ärztekammer Nordrhein beurteilten die Behandlung als fehlerhaft.

Laserbehandlungen zählen insgesamt zu den risikoreicheren Therapien in der Dermatologie. Häufiger als andere Behandlungsoptionen beurteilen die Begutachter die Behandlungen als fehlerhaft.

[Complications after laser treatment of facial vascular lesions]

Laser technology represents a major advance in the treatment of vascular changes. Excellent knowledge combined with technological advances in new laser sources form the basis of this safe and effective option in many acquired or congenital vascular changes on the face. With regard to the different laser sources, the pulsed dye laser (PDL) has the best efficacy-to-safety ratio. This type of laser remains the gold standard for vascular lesions. Neodymium-doped yttrium aluminium garnet (Nd: YAG) lasers and diode lasers, among others, as well as intensed pulsed light (IPL), play an important role in addressing vascular changes in the face. Good knowledge of the laser approach to vascular lesions and technological progress have led to safety features that seek to minimize side effects. These advances mainly include the introduction of cooled tips, cooling devices and cooling systems, changes in pulse duration, and the introduction of different wavelengths, among others. However, undesirable side effects can still occur. Although these are mostly discrete and resolve spontaneously, some complications can be serious and difficult to manage. Therefore, the prevention and early management of complications are all the more important in the treatment of vascular changes on the face.

The association between treatment reactions and treatment efficiency of Hemoporfin-photodynamic therapy on port wine stains: A prospective double blind randomized controlled trial

BACKGROUND

Research has focused on treatment efficiency and/or treatment reactions of photodynamic therapy (PDT) on port-wine stain (PWS). But few studies reported the association between them. Hence, here we investigated the association between the treatment efficiency and treatment reactions after Hemoporfin (HMME) mediated photodynamic therapy (PDT) on PWS through a prospective study.

METHODS

Patients (n=50) with PWS were randomly assigned to the HMME group or the placebo group. Three quit after the first treatment, and forty-seven received two sessions of treatment at an 8-week interval. They were given the treatment at day 1 and evaluations were performed at day 1, day 4 and week 8 in each session. HMME group was treated with HMME while the placebo group was given normal saline instead in the first session, double-blindly. While in the second session, both groups received HMME-PDT treatment.

RESULTS

After a single treatment, swelling was more severe in younger patients (p<0.05) and the lesion far from centro-facial showed more severe pruritus and scab. Compared with a single treatment, burning sensation had a higher occurrence rate, while burning sensation and scab were less severe in the second treatment. Importantly, severity of scab and pain (5min after irradiation) were found possibly correlated with the treatment efficiency.

CONCLUSION

HMME-PDT on PWS induces several treatment reactions, including pruritus, burning sensation, pain, swelling, blisters and scab. Two sessions of treatments do not have any accumulation effects on treatment reactions. And there might be a positive correlation between treatment efficiency and the severity of scab or pain (at early stage of the therapy), which might help in regulating treatment modalities.

X-ray absorption spectroscopy and density functional analysis of the Fe3+ distribution profile on Al sites in a chrysoberyl crystal, BeAl2O4:Fe3+

Chrysoberyl is one of the most interesting minerals for laser applications, widely used for medical purposes, as it exhibits higher laser performance than other materials. Although its utilization has been vastly expanded, the location of transition metal impurities, especially the iron that is responsible for chrysoberyl's special optical properties, is not completely understood. The full understanding and control of these optical properties necessitates knowledge of the precise location of the transition metals inside the structure. Therefore, synchrotron X-ray absorption spectroscopy (XAS), a local structural probe sensitive to the different local geometries, was employed in this work to determine the site occupation of the Fe3+ cation in the chrysoberyl structure. An Fe K-edge X-ray absorption near-edge structure (XANES) simulation was performed in combination with density functional theory calculations of Fe3+ cations located at different locations in the chrysoberyl structure. The simulated spectra were then qualitatively compared with the measured XANES features. The comparison indicates that Fe3+ is substituted on the two different Al2+ octahedral sites with the proportion 60% on the inversion site and 40% on the reflection site. The accurate site distribution of Fe3+ obtained from this work provides useful information on the doping process for improving the efficiency of chrysoberyl as a solid-state laser material.

Laser treatment of port-wine stains

Port-wine stains are a type of capillary malformation affecting 0.3% to 0.5% of the population. Port-wine stains present at birth as pink to erythematous patches on the skin and/or mucosa. Without treatment, the patches typically darken with age and may eventually develop nodular thickening or associated pyogenic granuloma. Laser and light treatments provide improvement through selective destruction of vasculature. A variety of vascular-selective lasers may be employed, with the pulsed dye laser being the most common and well studied. Early treatment produces more optimal results. Advances in imaging and laser treatment technologies demonstrate potential to further improve clinical outcomes.

[Therapeutic indications for percutaneous laser in patients with vascular malformations and tumors]

Lasers are increasingly used to treat vascular abnormalities. Indeed, this technique is non-invasive and allows a specific treatment. The aim of this review is to present some biophysical principles of the lasers, to describe the different sorts of lasers available for treatment in vascular medicine indications. Three principal lasers exist in vascular medicine: the pulsed-dye laser, for the treatment of superficial pink lesions, the NdYAG-KTP laser for purple and bigger lesions, and the NdYAG long pulse laser for even deeper and bigger vascular lesions. In vascular malformations, port wine stains can also be treated by pulsed-dye laser, KTP or NdYAG when they are old and thick. Telangiectasias are good indications for the three sorts of lasers, depending on their depth, color and size. Microcystic lymphatic malformations can be improved by laser treatment. Arterio-venous malformations constitute a contraindication of laser treatment. In vascular tumors, involuted infantile hemangiomas constitute an excellent indication of pulsed-dye laser treatment. Controlled studies are necessary to evaluate and to compare the efficacy of each laser, in order to determine their optimal indications and optimal parameters for each machine.

Co2/Erbium:YAG/Dye laser combination: an effective and successful treatment for angiofibromas in tuberous sclerosis

BACKGROUND

Tuberous sclerosis, an autosomal dominant neurocutaneous syndrome seen in approximately 1 in 6,000 people worldwide, is characterized by the appearance of hamartomas in multiple organs. The classic clinical triad consists of angiofibromas, epilepsy, and developmental delay. Dermatologic disorder is one of the main characteristics. Angiofibromas, a common form of presentation, causes significant cosmetic and medical problems. The current treatment for skin lesions is laser therapy. The carbon dioxide (CO2) laser has been used satisfactorily in treating these lesions, but several studies have demonstrated a high percentage of recurrences. Erbium:yttrium-aluminum-garnet (YAG) laser treatment has been used to resurface skin abnormalities in patients with dermatologic conditions. The dye laser as an alternative uses the principles of selective photothermolysis and is very effective in treating the vascular component of tuberous sclerosis. The use of all these lasers to treat skin lesions in patients affected by tuberous sclerosis has never been described in the literature.

METHODS

A retrospective study, conducted from 2007 to May 2013, investigated 13 patients who had tuberous sclerosis treated with an erbium:YAG/CO2/dye laser combination.

RESULTS

All the patients showed great improvement of their skin lesions. The results were evident immediately after the first treatment. No patient experienced complications or recurrence.

CONCLUSIONS

The combined use of the erbium:YAG/Dye/CO2 laser is a safe and effective treatment for skin lesions in patients affected by tuberous sclerosis.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A rare case of lymphangioma in the gluteal region: surgical treatment combined with sclerotherapy and laser therapy

BACKGROUND

Lymphangioma, a rare benign malformation of lymphatic channels, is among the surgically treatable diseases of the lymphatic vessels. However, damage to surrounding structures together with incomplete resection due to adjacent organ infiltration and a high recurrence rate have encouraged the search for alternative treatments. This study aimed to identify the best therapeutic management for this difficult-to-treat disease.

METHODS

This report describes a case of congenital lymphangioma in the gluteal region in a young woman. First, sclerotherapy of the lymphangioma was performed and then surgical excision of residual lesions. Finally, as a third therapeutic step, the patient also was subjected to a cycle of laser therapy with the aim of further improving the appearance of the gluteal region. Pulsed dye laser was used to remove cutaneous dyschromias, and an erbium:yttrium-aluminum-garnet laser was used to remove surface irregularities and obtain better skin smoothness. The outcome assessments included standardized photography, the physician's global assessment, the patient's satisfaction scores, and magnetic resonance imaging of the gluteal region.

RESULTS

All the lesions of lymphangioma were removed. After the last laser treatment, the skin of the entire treated region was eutrophic and uniform in color, and it appeared to be smooth and soft when palpated. The patient was satisfied with the clinical and aesthetic results achieved.

CONCLUSIONS

The combination of sclerotherapy with surgery can be a good solution for the treatment of lymphangioma. The authors also propose laser therapy as an additional therapeutic approach that may follow surgery or sclerotherapy with the aim of improving the skin trophism and the appearance of the affected region.

The use of interstitial echo-guided diode laser 980-nm for deep vascular anomalies in pediatric patients: a preliminary study

A wide range of therapeutic options is available to treat vascular anomalies, arising from the systemic therapies to surgery or using lasers. The purpose of this preliminary study is to assess the effectiveness of treatment of vascular anomalies anywhere in the body, along with the use of interstitial echo-guided 980 nm diode laser. The analysis occurs through accurate angio magnetic resonance imaging (MRI) pre- and post-treatment measurements. We enrolled all the patients (16) affected on vascular malformations everywhere in the body, treated from January to August 2012. We obtained excellent results in 6 patients (37.5%) with mean mass reduction of 85%, good in 9 patients (56%) with mean mass reduction of 65% and unsatisfactory in 1 patient (6%). In pediatric patients, low-flow vascular malformations resistant to progressive sclerotherapy or in critical anatomical sites, benefit of echo guided interstitial 980-nm diode laser.

Laser use in infantile hemangiomas, when and how

Infantile hemangiomas (IHs) are proliferating embrional tumors which can stem from placented tissue and are constituted by endothelial cell hyperproliferation. The management of the IHs is always challenging for all the specialists because of the heterogeneous behavior of these lesions. The factors leading to an aggressive position are essentially these: the prevention or reduction of aesthetic risks, the prevention or treatment of ulcerated hemangiomas, the prevention or impairment of functional risks and pain, and the removal of life-threatening risks. The treatment of vascular lesions is one of the mostly sought and performed cutaneous laser procedures, and in the field of IH treatments the more used laser devices certainly are pulsed dye lasers. Early laser therapy is able to reduce the possibility that the lesion will reach its full size, preventing several complications, connected to the hemangioma's growth, and providing psychological relief for pediatric patients and their parents.

[New developments in laser therapy]

Based on the theory of stimulated emission of radiation that was proposed by Albert Einstein in 1916, the first lasers were developed in the 1960s. The first clinical use of laser technology in a German university took place in 1978 in the Department of Dermatology of the Ludwig-Maximilian-University in Munich under the guidance of the former director, Prof. Dr. med. Dr. h.c. mult. Otto Braun-Falco. In the following years, laser technology developed rapidly. Today laser technology is a widely used interdisciplinary therapeutic procedure that has deep clinical and scientific roots in dermatology. There are many conditions in both classic and aesthetic dermatology that are routinely - and sometimes exclusively - treated with lasers. Here we review recent developments in laser medicine. There seems to be a trend to combination procedures. To enhance efficacy, different laser systems are together or lasers are combined with specific topical medications.

Misconceptions about laser treatment among dermatology patients

BACKGROUND

The use of lasers is very common in dermatology; however, many patients fear it and have various misconceptions about it. A literature search failed to show any studies on this topic.

OBJECTIVE

To explore the various misconceptions of patients about lasers in dermatology.

METHODS

A self-administered questionnaire containing 21 questions about laser use in dermatology was distributed randomly to patients attending the dermatology clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, from February to April 2009.

RESULTS

The response rate was 79.3%, with 714 of the 900 distributed questionnaires being returned; the individuals sampled included 348 men (48.73%). When asked about the nature of laser, 40% (279 of 698) reported that they did not know. About 36% (251 of 698) knew it was radiation of stimulated light amplification, while 10.2% (71 of 698) reported it to be nuclear radiation. Among study participants, 51.5% (364 of 707) believed that laser was harmful to children, while 51.1% (357 of 699) believed it was unsafe during pregnancy, and 21.4% (146 of 683) thought it could cause skin cancer. Laser was believed to treat most skin diseases by 47.7% (330 of 692) of those interviewed, among whom 24.1% said that they would not accept laser treatment if it was suggested to them by a dermatologist. A stance against laser (16.3%) was most common among men (P<0.001), the illiterate (P=0.006), and those with lower education (P=0.001).

CONCLUSION

Various misconceptions about laser treatment among patients are prevalent, especially among less educated individuals. Educating the community about laser could solve this problem.

Clinical analysis of port wine stains treated by intense pulsed light

BACKGROUND

Port wine stains (PWS) are formed by dilation and malformation of dermal capillaries without endothelium proliferation. Despite the improvements in lasers and light therapy for PWS therapy in the past 10 years, the 'cure' rate is only about 10%. Intense pulsed light (IPL) is a non-coherent light based on the theory of selective photothermolysis.

OBJECTIVE

To evaluate the efficacy of a new IPL on PWS.

METHODS

Seventy-two patients with PWS treated with an IPL with synchronous cooling were retrospectively analyzed. According to AQ1: sentence re-punctuated in places. Please check through and confirm correct the Fitzpatrick skin type, color, location of the lesion, and treatment reaction, light filters of 560 nm 590 nmor 640 nm were used with a single pulse with a pulse width of 6-14 ms and a fluence of 16-29 J/cm2; a double pulse with a pulse width of 3.5-4.0 ms, a pulse delay of 20-30 ms, and a fluence of 17-23 J/cm2; or a triple pulse with a pulse width of 3.0-4.0 ms, a pulse delay of 20-40 ms, and a fluence of 18-22 J/cm2. The adverse effects and the relationships among the lesion type, treatments, ages and location were analyzed.

RESULTS

Most of the PWS lesions faded significantly and the response rate in this series was 76.4%. Patients resistant to other forms of therapy also showed good clinical results. Adult lesions were easier to remove than those in younger individuals. Further improvement did not occur after three treatments. We failed to find any relationship between efficacy and location of the PWS.

CONCLUSION

The IPL treatment modality is safe and efficient for the treatment of PWS and for those which may be resistant to other therapies. The IPL is an alternative method for most PWS lesions.

Photoacoustic imaging of port-wine stains

BACKGROUND AND OBJECTIVE

To optimize laser therapy of port-wine stains (PWSs), information about the vasculature as well as lesion depth is valuable. In this study we investigated the use of photoacoustic imaging (PAI) to obtain this information.

STUDY DESIGN/MATERIALS AND METHODS

PAI uses pulsed light to generate ultrasound upon absorption of short light pulses by blood. In this study we used PAI to image vasculature in PWSs in three human volunteers. Two-dimensional imaging (scan direction vs. depth) was carried out by scanning a double-ring photoacoustic sensor over the tissue surface.

RESULTS

In the photoacoustic images we observed an increased photoacoustic signal intensity at the locations of the PWS that is associated with increased vascularization. From the obtained images we measured the thickness of the vascular layer and estimated lesion depth. In some cases single vessels could be observed at the position of the PWS whereas in other cases the PWS appeared as a region with large photoacoustic signal intensity.

CONCLUSIONS

PAI has the potential to reveal information about the lesion depth as well as thickness of the vascular layer.

Treatment of hemangioma of the head and neck with diode laser and forced dehydration with induced photocoagulation

OBJECTIVE

The aim of this study was to investigate the efficacy of treating oral hemangiomas using forced dehydration with induced photocoagulation (FDIP) via diode laser.

METHODS

One-hundred sixty patients were treated between 1999 and 2006 (76 men, 46%; 84 women, 54%). In 136 cases we used FDIP to treat hemangioma, and in 24 cases complete surgical excision was performed. One-hundred thirty-four lesions had a surface area <2 x 2 cm2, whereas only two had large lesions measuring 2.5 x 2 cm2.

RESULTS

In 136 patients with hemangiomas treated with FDIP, 134 cases (98.53%) showed complete remission, one case (0.735%) did not show complete remission, and one case (0.735%) displayed tumor growth. There were no adverse effects and all patients were carefully followed-up until complete healing was documented, along with any complications.

CONCLUSIONS

Our findings suggest that FDIP is a useful and effective treatment for benign oral vascular lesions. FDIP treatment of these oral lesions is clinically significant because it provides effective management, avoids recurrence, and shortens healing time. We believe that the use of this method by medical and dental specialists should be supported.