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

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.

Orofacial hereditary haemorrhagic telangiectasia: high power diode laser in early and advanced lesion treatment

“…This efficient, handle and advanced medical device was employed with a fibre of 320µm, a wavelength of 800±10nm, and an energy output ranging from 14 to a maximum of 20 Watt. This Laser was selected because of its affinity to the oxyhaemoglobin that provoke a photothermolysis, and erythrocytes micro-agglutination, producing vessels obliteration and reducing haemorrhage risks [37][38] . Each patient has been treated in multiple Laser sessions according to the number and the extension of telangiectasia.…”

Diode Laser Photocoagulation of Oral Venous Malformations in Patients on Anticoagulant Therapy Without Drug Discontinuation

“…The latter are subclassified as follows: (a) simple; (b) combined, when two or more vascular malformation types are found in a single lesion; (c) anomalies of major vessels, also known as "channel type" or "truncal" VMs; anomalies of (d) origin, (e) course, (f) number, (g) length, (h) diameter; the last group also includes syndromic VMs associated with other anomalies. Diode lasers are generally accepted as effective medical devices to treat VMs in the head and neck as providing a targeted selectivity for oxyhemoglobin, induction of photothermolysis and erythrocyte microagglutination and vessel obliteration [5][6][7][8][9]. Anticoagulant therapy is usually modified or suspended in patients needing oral surgery procedures to prevent intra-and postoperative bleeding, especially for vascular lesions treatment.…”

Oral vascular malformations: laser treatment and management

“…Global incidence is not known, but in the last decades it is gradually increasing. 1 Vascular lesions occur at higher frequency in the Head and Neck region compared to other parts of the body. Most of the cases are sporadic forms, that appear in patients without positivity in their familiar history.…”