Evaluation of interventional Nd : Yag laser surgery treatment of soft-tissue hemangiomas and vascular malformations of the oral cavity: a clinical study

ABSTRACT

The treatment of vascular malformations remains controversial because the oral and max-illofacial surgeon must always balance potential morbidity with projected benefit. A minimally in-vasive technique is described, with the neodymium yttrium-aluminium-garnet [NdYAG] laser being used for interstitial photocoagulation of hemangiomas and vascular malformations in a series of twelve patients of mean age 12.4 years. Interstitial photocoagulation was performed by using the fiber-based NdYAG laser. This was accomplished by introducing the laser fiber with an angiocath and delivering various amounts of energy [6VV to 10W]. There were no complications. The procedures were easy to perform and well tolerated, with all patients being discharged on the same day of surgery. The following outcome measures were statistically analyzed Decrease in the area of the target lesion, [% reduction] and number of treatments required to achieve reduction in size and their relation to size of the lesion. A follow up period of 6 months showed no regression in all but 2 patients with good cosmetic results. The range of reduction in size was 100% for hemangiomas while it ranged from 71.6%[2 weeks postoperative] to 96.2% at 6 months for capillary malformations. Capillary malformations needed greater number of sessions to be fully treated with a highly sig-jjficant p value [p< 0.00]]. The percent reduction in size was significantly different in capillary malformations than for hemangiomas at 3rd day, 2nd week, till the end of the follow up period. Correlation between the number of sessions needed and the size of the lesion showed a relatively high coefficient of positive correlation [r =.67]. Interstitial NdYAG laser photocoagulation offers the oral surgeon a therapeutic alternative in the treatment of refractory vascular malformations or in cases where there is a considerable projected surgical morbidity. Although multiple treatments may be required, the procedure is effective, simple and well tolerated