J Oral Laser Applications 10 (2010), No. 2-3 (20.12.2010)
Treatment of Deep Vascular Lesions using Ultrasound-guided Intralesional Laser Photocoagulation
Vesnaver, Ales / Perovic, Alenka Visnar / Cernelc, Bojana
Purpose: The treatment of large, deep-seated vascular lesions in the orofacial region is often very challenging. The Nd:YAG laser has already proved to be an effective mode of treatment for vascular lesions. Our goal was to determine the efficacy and safety of ultrasound (US) guided Nd:YAG laser treatment of deep-seated vascular lesions.
Patients and Methods: A prospective study was conducted in which 9 patients with deep vascular lesions in the orofacial region were treated under local anaesthesia with US-guided photocoagulation (PhC) using the Nd:YAG laser. The same US probe as used for US-guided aspiration biopsy was used for the procedure, with the fiber-optic cable inserted into the needle mounted on the US probe. The needle was then inserted directly into the lesion, its position clearly visible on the screen. Photocoagulation was then performed in a systematic sequence under US control, until the whole vascular lesion was coagulated. Follow-up was conducted in all of the cases, time until resolution of swelling was recorded, as were also postoperative complications.
Results: In patients undergoing intralesional PhC, there was no tissue sloughing as the surface epithelium was not injured. Swelling was present for about one week. There were no cases of inadvertent bleeding. Three patients required two sessions of US-guided PhC. One patient developed a local intraoral infection, which was controlled with broad spectrum oral antibiotics.
Conclusion: US-guided laser photocoagulation is a safe and effective tool for the treatment of large vascular lesions.
Keywords: hemangiomas, Nd:YAG laser, ultrasound, photocoagulation, vascular malformations