Endoluminal sclerosis with diode laser in the 
treatment of orofacial venous malformations

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Abstract

Introduction: The appearance of vascular anomalies in the orofacial area is a common condition, which represents about 50% of these malformations. Traditional treatment approach, such as surgery and chemical sclerosis has been given way to a few less-invasive options, as the use of the 810nm diode laser to induce the sclerosis of the venous malformation by intralesional photocoagulation. Objectives: The objective of this study was to determine the efficacy of the diode laser in the intralesional treatment of the orofacial venous malformations (OFVM), describing the recommended surgical approach, as well as to report the main associated complications. Patients and Methods: 10 cases of OFVM, diagnosed and treated at the Oral Surgery Department of the Dental Clinic of the University of Barcelona, between January, 2009 and April, 2011. Every case was treated under local anesthesia, performing at least one intralesional session of diode laser, applying an 1W active optic fiber, in continuous mode, inserted into the interior of the lesion through an intramuscular needle, from the deepest portion to the surface of the lesion. Postoperative medication was indicated and follow-up visits were perform during a period of at least 6 months. Results: Of a total of 10 cases of OFVM, mean age of 25.4 years, 8 required just a single session with intralesional laser diode, before the clinical verification of a total reduction of size of the lesion. In 2 of these cases, were needed at least 2 sessions of intralesional photocoagulation to reach a satisfactory cosmetic result. No complications of any kind occurred. After a follow-up period of at least 6 months only a case of recurrence was described. Discussion and Conclusions: The advantages associated to the use of non-invasive techniques in the treatment of OVM, along with the success rate and low number of relapses, shows the use of the diode laser as a therapy to be considered in the treatment of these lesions. A higher case mix would be essential for definitive conclusions.

Key words:Diode laser, hemangioma, orofacial venous malformation.

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Most cited references 13

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Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics.

J Mulliken, J Glowacki (1982)

Forty-nine specimens from a variety of vascular lesions were analyzed for cellular characteristics. Two major categories of lesions emerged from this investigation: hemangiomas and vascular malformations. This classification and its implications are justified by several considerations. Hemangiomas in the proliferating phase (n = 14) were distinguished by (1) endothelial hyperplasia with incorporation of [3H]thymidine, (2) multilaminated basement membrane formation beneath the endothelium, and (3) clinical history of rapid growth during early infancy. Hemangiomas in the involuting phase (n = 12) exhibited (1) histologic fibrosis and fat deposition, (2) low to absent [3H]thymidine labeling of endothelial cells, and (3) rapid growth and subsequent regression. The endothelium in hemangiomas had many characteristics of differentiation: Weibel-Palade bodies, alkaline phosphatase, and factor VIII production. Vascular malformations (n = 23) demonstrated no tritiated thymidine incorporation and normal ultrastructural characteristics. These lesions were usually noted at birth, grew proportionately with the child, and consisted of abnormal, often combined, capillary, arterial, venous, and lymphatic vascular elements. This cell-oriented analysis provides a simple yet comprehensive classification of vascular lesions of infancy and childhood and serves as a guide for diagnosis, management, and further research.

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Micropulsed diode laser therapy: evolution and clinical applications.

Sobha Sivaprasad, Mohammed Elagouz, Dominic McHugh … (2015)

Many clinical trials have demonstrated the clinical efficacy of laser photocoagulation in the treatment of retinal vascular diseases, including diabetic retinopathy. There is, however, collateral iatrogenic retinal damage and functional loss after conventional laser treatment. Such side effects may occur even when the treatment is appropriately performed because of morphological damage caused by the visible endpoint, typically a whitening burn. The development of the diode laser with micropulsed emission has allowed subthreshold therapy without a visible burn endpoint. This greatly reduces the risk of structural and functional retinal damage, while retaining the therapeutic efficacy of conventional laser treatment. Studies using subthreshold micropulse laser protocols have reported successful outcomes for diabetic macular edema, central serous chorioretinopathy, macular edema secondary to retinal vein occlusion, and primary open angle glaucoma. The report includes the rationale and basic principles underlying micropulse diode laser therapy, together with a review of its current clinical applications. Copyright © 2010 Elsevier Inc. All rights reserved.

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Diode laser (980 nm) in oral and maxillofacial surgical procedures: clinical observations based on clinical applications.

G Romanos, G Nentwig (1999)

The aim of this study was to examine the wound healing of soft tissue after the application of a diode laser (980 nm) in oral surgical procedures. Like the CO2 laser, the diode laser can be used for soft tissue surgery without extensive experience in the field of oral surgical. A diode laser was used to treat a variety of oral soft tissue lesions in 22 patients. The oral surgical procedures included removal of soft tissue tumors, frenectomies, excision of gingival hyperplasias, vestibuloplasties, hemangioma removal, and periimplant soft tissue surgery. The laser was used in both pulsed and continuous modes, with and without contact to the tissue. Intraoperative and postoperative clinical observations are reported. Our preliminary clinical findings include sufficient hemostasis and precise incision margin with all of the surgical procedures. The coagulation properties, associated with the use of a diode laser, were particularly beneficial during removal of vascular lesions. The postoperative advantages, i.e., lack of swelling, bleeding, pain or, scar tissue formation, and the good wound healing were observed in all of the clinical applications and were dependent only on the laser physical parameters used. The clinical application of the diode (980 nm) laser in oral and maxillofacial surgical procedures seems to be of beneficial effect for daily practice.

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Author and article information

Journal

Journal ID (nlm-ta): Med Oral Patol Oral Cir Bucal

Journal ID (iso-abbrev): Med Oral Patol Oral Cir Bucal

Journal ID (publisher-id): Medicina Oral S.L.

Title: Medicina Oral, Patología Oral y Cirugía Bucal

Publisher: Medicina Oral S.L.

ISSN (Print): 1698-4447

ISSN (Electronic): 1698-6946

Publication date (Print): May 2013

Publication date (Electronic): 25 March 2013

Volume: 18

Issue: 3

Pages: e486-e490

Affiliations

[1 ]DDS. Resident of the Master of Oral Surgery and Implantology. University of Barcelona Dental School

[2 ]DDS, MD,PhD. Associate Professor of Oral Surgery. School of Dentistry of the University of Barcelona. Investigator of the IDIBELL Institute. Director of the Master of Dentistry Laser. University of Barcelona. Coordinator of the European Master Degree in Oral Laser Applications (EMDOLA)

[3 ]MD, DDS, PhD. Chairman and Professor of Oral and Maxillofacial Surgery. Director of the Master of Oral Surgery and Implantology. School of Dentistry of the University of Barcelona. Coordinator/Researcher of the IDIBELL Institute. Head of the Oral and Maxillofacial Surgery Department of the Teknon Medical Center, Barcelona (Spain)

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Centro Médico Teknon C/ Vilana 12 08822 - Barcelona , E-mail: cgay@ 123456ub.edu

Article

Publisher ID: 18528

DOI: 10.4317/medoral.18528

PMC ID: 3668877

PubMed ID: 23524425

SO-VID: 01a944f4-8c93-43f2-a64a-8ec6f5f78e33

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Endoluminal sclerosis with diode laser in the treatment of orofacial venous malformations

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Karger: Gastroenterology

Most cited references 13

Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics.

Micropulsed diode laser therapy: evolution and clinical applications.

Diode laser (980 nm) in oral and maxillofacial surgical procedures: clinical observations based on clinical applications.

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