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Almothahbi A, Bukhari M, Almohizea M, Alsubaie N, Alharbi TF, Alhazzani HM, Zagzoog F. Recent updates in laryngeal hemangioma management: a scoping review. Eur Arch Otorhinolaryngol 2024; 281:2211-2222. [PMID: 38158419 DOI: 10.1007/s00405-023-08378-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To provide a comprehensive review of the current strategies in the management of laryngeal hemangiomas, with an aim to introduce a management algorithm that aligns with the variable clinical presentations and anatomical complexities of these lesions. METHODS We conducted an extensive literature search across major databases using specific and general terms, combined with Boolean operators, to ensure comprehensiveness. Articles from January 2004 to August 2023 were included, with findings categorized by management approach. RESULTS Laryngeal hemangiomas exhibit a spectrum of manifestations, ranging from asymptomatic lesions to those causing severe airway obstruction. Optimal management demands an individualized approach tailored to the patient's unique presentation and anatomical considerations. Diverse treatment modalities, each with distinct indications, advantages, and limitations, are explored. Notable highlights encompass the prominent role of Beta-blockers, notably Propranolol, in addressing problematic infantile hemangiomas, the nuanced efficacy of laser therapies contingent upon hemangioma type and depth, and the critical relevance of tracheotomy in emergencies. Novel approaches like transoral robotic surgery and transoral ultrasonic surgery, demonstrate promise in specific scenarios. We propose a management algorithm based on the complexity and presentation of laryngeal hemangiomas, emphasizing individualized treatment strategies, thereby addressing the unique challenges and nuances of each case. CONCLUSION Laryngeal hemangioma management requires personalized approaches informed by diverse therapies, clinical expertise, and collaboration. The review introduces an algorithm spanning observation to advanced interventions, adapting to each case's complexity. Ongoing research promises innovative treatments.
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Affiliation(s)
- Ali Almothahbi
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia.
| | - Manal Bukhari
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Nawaf Alsubaie
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Talal F Alharbi
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Faisal Zagzoog
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
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Heimlich FV, Arruda JAAD, Kato CDNADO, Silva LVDO, Souza LN, Ferreira MVL, Pinheiro JDJV, Silva TA, Abreu LG, Mesquita RA. Experience with 808-nm diode laser in the treatment of 47 cases of oral vascular anomalies. Braz Oral Res 2024; 38:e025. [PMID: 38597545 DOI: 10.1590/1807-3107bor-2024.vol38.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/20/2023] [Indexed: 04/11/2024] Open
Abstract
Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.
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Affiliation(s)
- Fernanda Vieira Heimlich
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila de Nazaré Alves de Oliveira Kato
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leni Verônica de Oliveira Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leandro Napier Souza
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcus Vinicius Lucas Ferreira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Ziad K, Badi J, Roaa Z, Emily AH. Laser treatment of infantile hemangioma. J Cosmet Dermatol 2023; 22 Suppl 2:1-7. [PMID: 36774645 DOI: 10.1111/jocd.15671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/10/2023] [Accepted: 01/25/2023] [Indexed: 02/13/2023]
Abstract
BACK GROUNDS AND OBJECTIVE Infantile hemangiomas (IH) are common benign tumors of infancy. Most IH either involute spontaneously or respond to treatment with systemic Beta- blockers, but unfortunately not in all cases. In poor responses or in cases of contra indications for pharmacological treatment, laser treatment poses a very good solution. METHODS As a search strategy and study selection we searched the MEDLINE database via PubMed starting 1982 to June 2022 using a key terms related to interventions for IH (e.g., infantile hemangioma, laser, Beta blockers). RESULTS In this article, we reviewed the published data regarding the use of energy-based devices in treatment of children with IH, and noted our experience over the course of treating dozens of cases over the years. CONCLUSION There are many laser systems used for the treatment of hemangioma and vascular tumors. These laser systems are of different wavelengths and penetration depths, however, they operate by similar mechanisms and in some cases two or more lasers can be applied during the course of treating these lesions.
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Affiliation(s)
- Khamaysi Ziad
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Jiryis Badi
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Zoabi Roaa
- Clalit Medical Services, Tel Aviv-Yafo, Israel
| | - Avitan-Hersh Emily
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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Khamaysi Z, Pam N, Zaaroura H, Avitan-Hersh E. Nd:YAG 1064-nm laser for residual infantile hemangioma after propranolol treatment. Sci Rep 2023; 13:7474. [PMID: 37156812 PMCID: PMC10167233 DOI: 10.1038/s41598-023-33870-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/20/2023] [Indexed: 05/10/2023] Open
Abstract
Infantile hemangiomas (IH) are common benign tumors of infancy. Most IH involute, either spontaneously, or secondary to pharmacological treatment with systemic propranolol. Propranolol treatment mostly leads to regression of hemangiomas with satisfactory aesthetic results, but unfortunately not in all cases. To assess the safety and efficacy of long pulsed Nd:YAG 1064 nm laser in treating patients with residual infantile hemangioma after systemic propranolol treatment. This is an open-label prospective cohort study. 30 patients with focal residual IH that had sub-optimal responses to systemic propranolol treatment were enrolled in the study. The patients were treated with 1 to 3 sessions with long pulsed Nd:YAG 1064 nm laser. The maximal response of the IH was assessed using a 4-point scale evaluation scale system. Of the 30 patients enrolled, 18 patients exhibited a great response (> 76% improvement), 10 patients had a good response (> 51-75% improvement), while only 2 patients showed a moderate response (< 50% improvement) to the treatment. No patients had an unsatisfactory response. No serious side effects were observed, and only minor side effects were reported. The treatment with long pulsed Nd:YAG 1064 nm laser for residual IH, which were resistant to systemic propranolol treatment, is safe and effective. Thus, we suggest its use as a second-line treatment for patients with sub-optimal aesthetic results following systemic propranolol.
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Affiliation(s)
- Z Khamaysi
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
| | - N Pam
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - H Zaaroura
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - E Avitan-Hersh
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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Nunez JH, Strong AL, Comish P, Hespe GE, Harvey J, Sorkin M, Levi B. A Review of Laser Therapies for the Treatment of Scarring and Vascular Anomalies. Adv Wound Care (New Rochelle) 2023; 12:68-84. [PMID: 35951024 DOI: 10.1089/wound.2021.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Significance: Laser use has become part of the gold standard of treatment as an effective adjuvant in multimodal therapy for pathologic scarring caused by burns, trauma, acne, and surgery, as well as vascular anomalies. Understanding indications and applications for laser therapy is essential for physicians to improve patient outcomes. Recent Advances: Since the 1980s, the medical use of lasers has continuously evolved with improvements in technology. Novel lasers and fractionated technologies are currently being studied in the hopes to improve treatment efficacy, while reducing complications. Recent advancements include acne treatment with novel picosecond lasers, new hypertrophic scar therapies with simultaneous laser and intense pulsed light use, and novel systems such as lasers with intralesional optical fiber delivery devices. In addition, optimizing the timing of laser therapy and its use in multimodal treatments continue to advance the field of photothermolysis. Critical Issues: Selecting the correct laser for a given indication is the fundamental decision when choosing a laser balancing effective treatment with minimal complications. This article covers the principles of laser therapy, the preferred lasers used for the treatment of scarring and vascular anomalies, and discusses the current evidence behind these laser choices. Future Directions: To optimize laser therapy, larger randomized control trials and split scar studies are needed. Continued advancement through better randomized controlled studies will help to improve patient outcomes on a broader scale.
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Affiliation(s)
- Johanna H Nunez
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amy L Strong
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Comish
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Geoffrey E Hespe
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jalen Harvey
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Sorkin
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Benjamin Levi
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Kaur Hora M, Choudhary N, Agrawal S, Gupta S, Gandhi J, De A, Chatterjee G. Evaluation of the Efficacy and Safety Profile of Long-Pulsed 1064 Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) Laser in Hemangioma and Vascular Malformation in Darker Skin Types. Cureus 2022; 14:e25742. [PMID: 35812578 PMCID: PMC9270095 DOI: 10.7759/cureus.25742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction A prospective, interventional study was conducted to evaluate the efficacy and safety profile of long-pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in the treatment of vascular lesions in the darker skin patients of Fitzpatrick skin type IV and V. Materials and method The study was conducted at a tertiary care hospital. Institutional ethical committee permission was obtained before starting the study. Twenty-nine patients presenting with vascular lesions were enrolled in the study. The patients were called once a month for sessions for six months. Clinician Global Impression (CGI) scores were used for evaluation. We followed a “per protocol” analysis. Results Of the 29 patients we enrolled, three dropped out for various logistic reasons, and 26 patients completed their treatment. After six months of follow-up of the 26 patients who completed their treatment, 12 (46.15%) had shown complete healing (CGI = 4, 70%-100% improvement in lesions). The rest of the 14 (53.84%) patients showed good improvement (CG1 = 3, reduction of 50%-70% of lesions). No permanent side effects were noted. Conclusion Long-pulsed 1064 Nd:YAG laser proves to be an effective treatment for hemangioma and vascular malformation in darker skin patients with its major advantages of being a safe, well-tolerated, cost-effective procedure with minimal downtime and minimal side effects.
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Kowalska M, Dębek W, Matuszczak E. Infantile Hemangiomas: An Update on Pathogenesis and Treatment. J Clin Med 2021; 10:jcm10204631. [PMID: 34682753 PMCID: PMC8539430 DOI: 10.3390/jcm10204631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/25/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Abstract
Infantile hemangiomas are the most common benign vascular tumors in infancy. This review includes an update on the current knowledge on pathogenesis, a discussion on indications for treatment, and a review of the mechanisms underlying the different treatment methods. Although most infantile hemangiomas require only active observation because of their natural course, which results in involution, about 10% present with complications that require immediate treatment. The basic treatment includes systemic and topical options. In cases of insufficient response or rebound growth, other forms of treatment should be considered. In some cases, combined therapy might be initiated.
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Jiang JC, Xu Q, Fang S, Gao Y, Jin WW. Sequelae After Involution of Superficial Infantile Hemangioma: Early Intervention with 595-nm Pulsed Laser Combined with 755-nm Long-Pulsed Alexandrite Laser versus Wait-and-See. Clin Cosmet Investig Dermatol 2021; 14:37-43. [PMID: 33469332 PMCID: PMC7811447 DOI: 10.2147/ccid.s279140] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022]
Abstract
Background and Objective Infantile haemangioma (IH) is the most common benign tumor in children. At present, pulsed dye laser (PDL) has made great progress in the treatment of superficial IH, showing good safety and effectiveness. But some doctors think that superficial IH should choose to wait-and-see. However, studies have reported that most of the IH after resolution still has residual disease, and thickness seems to be an important factor. Therefore, the purpose of this study is to investigate the relationship between Sequelae and thickness after superficial IH involution. In addition, compare the Sequelae difference between 595-nm pulsed laser combined with 755-nm long-pulse alexandrite laser treatment and wait-and-see. Materials and Methods This retrospective observational study included patients with superficial IH evaluated in the past 6 years and divided them into a laser group and an observation group. Results The incidence of sequelae in the laser group was 44.6%, and the incidence of sequelae in the observation group was 69.5%. The incidence of Sequelae of superficial IH in the laser group was significantly lower than that in the observation group (χ 2-test, χ 2=10.790, P <0.001). In the observation group, the average A scores of the three thickness subgroups (<2mm, 2-5mm, and >5mm) were 4.38, 3.39, and 1.80, and there were significant differences in the A scores between the three groups (Kruskal-Wallis, p<0.05). There is a significant difference in the A score between the laser group and the observation group in the superficial IH with a thickness of 2-5 mm and>5mm (Wilcoxon rank sum test, P<0.05). Conclusion This retrospective study showed that the degree of Sequelae of superficial IH after involution is related to its thickness. In addition, the early intervention of 595-nm pulsed laser combined with 755-nm long-pulse alexandrite laser can reduce the incidence and extent of sequelae.
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Affiliation(s)
- Ji-Cong Jiang
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, People's Republic of China
| | - Qin Xu
- The Second School of Medicine, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, People's Republic of China
| | - Shan Fang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, People's Republic of China
| | - Yu Gao
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, People's Republic of China
| | - Wan-Wan Jin
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, People's Republic of China
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Combination Laser Treatment With Real-Time Ultrasound Navigation for Oral Venous Malformations. J Craniofac Surg 2020; 31:e772-e776. [PMID: 33136908 DOI: 10.1097/scs.0000000000006740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Vascular lesions, including hemangiomas and vascular malformations, are common benign diseases. More than 50% originate from blood vessels or vascular structures and are locate in the head and neck region. This study aimed to evaluate the efficiency and safety of a combination of laser treatments for oral venous malformations using ultrasound navigation. This study reports 3 cases of massive vascular malformation in the oral cavity, which were treated by a combination of a multiple spotted transmucosal irradiation technique (the so-called leopard technique) for the superficial layer, and intralesional photocoagulation for the deep layer using a neodymium-doped yttrium aluminum garnet laser, under real-time ultrasound navigation. All cases presented with a venous malformation with multiple blue swellings on the dorsum of the tongue, which had a maximum dimension of over 30 mm. The percent reduction in the size of the lesions was determined by magnetic resonance imaging. All cases showed a decrease in lesion volume of over 80%, without extensive tissue necrosis, 6 to 12 months after the laser treatment. None of the patients experienced any complications, and all were satisfied with the treatment outcome after one irradiation session.The results of this study suggest that laser treatment using ultrasound navigation is a promising approach for the safe and minimally invasive resolution of oral vascular lesions without scarring and loss of normal tissue architecture, sensation, oral function.
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Helal AA, Daboos MA. Five years’ experience of combined intralesional therapy in infantile hemangioma. ANNALS OF PEDIATRIC SURGERY 2019. [DOI: 10.1186/s43159-019-0008-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Infantile hemangiomas (IHs) are common vascular tumors. Although it involutes spontaneously, outcomes are unpredictable. Intralesional therapy is one of its treatment modality. We present our experience with combined intralesional therapy for IHs over a 5-year duration. A total of 427 patients were treated and followed at Al-Azhar University Hospitals during the study period of 5 years. All patients were treated by intralesional therapy in the form of combined injection of triamcinolone and bleomycin. All patients were followed for the response. Response to the treatment was graded as marked, partial, and poor improvement.
Results
IHs were noticed within the first month of life in 90.2% of patients. The commonest site of involvement was head and neck in 90% of patients. The commonest clinical presentation was swelling with discoloration. Mean age was 7.43 ± 6.04 months and mean IHs size was 15.54 ± 11.13 cm2. The response to the treatment was highest for patients below 1 year of age. The reported complications were ulceration, scarring, and subcutaneous atrophy in some cases.
Conclusion
Combined intralesional therapy in IHs showed good efficacy in most patients. It is a reliable and safe treatment modality with clear curative effects and minimal complications. If IHs treatment is indicated, combined intralesional therapy should be considered as an alternative effective treatment modality.
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Zutt M. Laser treatment of vascular dermatological diseases using a pulsed dye laser (595 nm) in combination with a Neodym:YAG-laser (1064 nm). Photochem Photobiol Sci 2019; 18:1660-1668. [PMID: 31124550 DOI: 10.1039/c9pp00079h] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There are many vascular anomalies which are often a diagnostic and therapeutic challenge. They are classified in vascular tumors (e.g. infantile hemangioma) or vascular malformations (e.g. port-wine-stain). Moreover there are several other and rare vascular disregulations and diseases in the field of dermatology. Many laser systems focus on the therapy of vascular pathologies. We use a pulsed dye laser (595 nm) on its own or in combination with a Neodym:YAG-laser (1064 nm) to treat those vascular diseases. This paper points out the advantages and side effects of these two laser systems and describes the limitations of those.
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Affiliation(s)
- Markus Zutt
- Department of Dermatology and Allergology, Klinikum Bremen-Mitte, Bremen, Germany.
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12
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Classification and treatment of orbital venous malformations: an updated review. Front Med 2018; 13:547-555. [PMID: 30097960 DOI: 10.1007/s11684-018-0623-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 12/06/2017] [Indexed: 12/21/2022]
Abstract
Orbital venous malformation (OVM) is a congenital vascular disease. As a common type of vascular malformation in the orbit, OVM may result in vision deterioration and cosmetic defect. Classification of orbital vascular malformations, especially OVMs, is carried out on the basis of different categories, such as angiogenesis, hemodynamics, and locations. Management of OVM is complicated and challenging. Treatment approaches include sclerotherapy, laser therapy, embolization, surgical resection, and radiotherapy. A satisfactory outcome can be achieved only by selecting the appropriate treatment according to lesion characteristics and following the sequential multi-method treatment strategy. This article summarizes the current classification and treatment advances in OVM.
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Miyazaki H, Ohshiro T, Romeo U, Noguchi T, Maruoka Y, Gaimari G, Tomov G, Wada Y, Tanaka K, Ohshiro T, Asamura S. Retrospective Study on Laser Treatment of Oral Vascular Lesions Using the "Leopard Technique": The Multiple Spot Irradiation Technique with a Single-Pulsed Wave. Photomed Laser Surg 2018; 36:320-325. [PMID: 29717920 DOI: 10.1089/pho.2017.4410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to retrospectively evaluate the efficacy and safety of laser treatment of oral vascular lesions using the multiple spot irradiation technique with a single-pulsed wave. BACKGROUND DATA In laser therapy for vascular lesions, heat accumulation induced by excessive irradiation can cause adverse events postoperatively, including ulcer formation, resultant scarring, and severe pain. To prevent heat accumulation and side effects, we have applied a multiple pulsed spot irradiation technique, the so-called "leopard technique" (LT) to oral vascular lesions. This approach was originally proposed for laser treatment of nevi. It can avoid thermal concentration at the same spot and spare the epithelium, which promotes smooth healing. The goal of the study was to evaluate this procedure and treatment outcomes. PATIENTS AND METHODS The subjects were 46 patients with 47 oral vascular lesions treated with the LT using a Nd:YAG laser (1064 nm), including 24 thick lesions treated using a combination of the LT and intralesional photocoagulation. RESULTS All treatment outcomes were satisfactory without serious complications such as deep ulcer formation, scarring, bleeding, or severe swelling. CONCLUSIONS Laser therapy with the LT is a promising less-invasive treatment for oral vascular lesions.
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Affiliation(s)
- Hidetaka Miyazaki
- 1 Department of Plastic and Reconstructive Surgery, Wakayama Medical University , Wakayama, Japan
| | - Takafumi Ohshiro
- 2 Plastic and Reconstructive Surgery, Ohshiro Clinic , Tokyo, Japan
| | - Umberto Romeo
- 3 Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome , Rome, Italy
| | - Tadahide Noguchi
- 4 Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University , Tochigi, Japan
| | - Yutaka Maruoka
- 5 Division of Dentistry/Oral and Maxillofacial Surgery, National Center for Global Health and Medicine , Tokyo, Japan
| | - Gianfranco Gaimari
- 3 Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome , Rome, Italy
| | - Georgi Tomov
- 6 Department of Oral Pathology, Faculty of Dental Medicine, Medical University of Plovdiv , Plovdiv, Bulgaria
| | - Yoshitaka Wada
- 1 Department of Plastic and Reconstructive Surgery, Wakayama Medical University , Wakayama, Japan
| | - Kae Tanaka
- 7 Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo, Japan
| | - Toshio Ohshiro
- 2 Plastic and Reconstructive Surgery, Ohshiro Clinic , Tokyo, Japan
| | - Shinichi Asamura
- 1 Department of Plastic and Reconstructive Surgery, Wakayama Medical University , Wakayama, Japan
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Chinnadurai S, Sathe NA, Surawicz T. Laser treatment of infantile hemangioma: A systematic review. Lasers Surg Med 2015; 48:221-33. [DOI: 10.1002/lsm.22455] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2015] [Indexed: 12/22/2022]
Affiliation(s)
| | - Nila A. Sathe
- Department of Health PolicyVanderbilt Evidence‐Based Practice CenterVanderbilt University Medical CenterNashvilleTennessee
| | - Tanya Surawicz
- Vanderbilt Evidence‐Based Practice CenterVanderbilt University Medical CenterNashvilleTennessee
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Shen L, Zhou G, Zhao J, Li P, Xu Q, Dong Y, Zhang Z. Pulsed dye laser therapy for infantile hemangiomas: a systemic review and meta-analysis. QJM 2015; 108:473-80. [PMID: 25376585 DOI: 10.1093/qjmed/hcu206] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Infantile hemangiomas (IH) are common pediatric tumors. This meta-analysis was performed to review the therapeutic efficacy and safety of pulsed dye laser (PDL) in the treatment of IH. METHODS Seven databases were searched, including PubMed, OvidSP, Karger, Elsevier, EMBASE, Web of Science and Wiley Online Library. The review collected the characteristics of year of publication, hemangiomas cases, prior treatment, laser parameters, adverse side, pretreatment symptom, and number of response from all articles. RESULTS A total of 1580 studies were identified, the first round search retrieved 39 articles met inclusion criteria. Of those, only 13 articles with 1529 hemangiomas were included in the meta-analysis. This meta-analysis demonstrated an overall resolution rate of 89.1% with 6.28% incidence of adverse effect. CONCLUSION PDL may be the effective modality to decrease the proliferative phase and accelerate rates of involution and resolution with few adverse events.
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Affiliation(s)
- L Shen
- From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - G Zhou
- From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - J Zhao
- From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - P Li
- From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Q Xu
- From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Y Dong
- From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Z Zhang
- From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China From the Department of Oral Maxillofacial-Head Neck Oncology, Laser&Cosmetic Center, Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, VIP Department, Stomatology Hospital of Shandong University, Jinan, China and Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
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Kaune KM, Lauerer P, Kietz S, Eich C, Thoms KM, Schön MP, Zutt M. Die Kombinationstherapie infantiler Hämangiome mit gepulstem Farbstofflaser und Nd:YAG-Laser ist wirksam und sicher. J Dtsch Dermatol Ges 2014. [DOI: 10.1111/ddg.12354_suppl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kjell M. Kaune
- Klinik für Dermatologie; Venerologie und Allergologie; Universitätsmedizin Göttingen
- Klinik für Dermatologie und Allergologie; Klinikum Bremen-Mitte; Bremen
| | - Peter Lauerer
- Klinik für Pädiatrische Hämatologie und Onkologie; Universitätsmedizin Göttingen
- Klinik für Pädiatrische Kardiologie und Intensivmedizin mit Neonatologie; Universitätsmedizin Göttingen
| | - Silke Kietz
- Klinik für Pädiatrische Hämatologie und Onkologie; Universitätsmedizin Göttingen
- Klinik für Pädiatrische Onkologie und Hämatologie; Universitätsmedizin Greifswald
| | - Christoph Eich
- Klinik für Anästhesiologie; Rettungs- und Intensivmedizin; Universitätsmedizin Göttingen
- Abteilung Anästhesie, Kinderintensiv- und Notfallmedizin; Kinder- und Jugendkrankenhaus Auf der Bult; Hannover
| | - Kai-Martin Thoms
- Klinik für Dermatologie; Venerologie und Allergologie; Universitätsmedizin Göttingen
| | - Michael P. Schön
- Klinik für Dermatologie; Venerologie und Allergologie; Universitätsmedizin Göttingen
| | - Markus Zutt
- Klinik für Dermatologie; Venerologie und Allergologie; Universitätsmedizin Göttingen
- Klinik für Dermatologie und Allergologie; Klinikum Bremen-Mitte; Bremen
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Kaune KM, Lauerer P, Kietz S, Eich C, Thoms KM, Schön MP, Zutt M. Combination therapy of infantile hemangiomas with pulsed dye laser and Nd:YAG laser is effective and safe. J Dtsch Dermatol Ges 2014; 12:473-8. [PMID: 24825388 DOI: 10.1111/ddg.12354] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 03/17/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Infantile hemangiomas (IH) can cause severe complications such as obstruction, ulceration or heart failure. Therefore, in certain difficult-to-treat areas, or when there is no sign of involution, early and effective therapy is required. In rare instances, systemic treatments, like the beta-blocker propranolol and oral corticosteroids, can cause serious side effects. Effective and well-tolerated local treatment options are thus desirable as additive or alternative methods. PATIENTS AND METHODS In this retrospective interdisciplinary study, 38 children with 77 IH were treated with pulsed dye laser (PDL) (595 nm) and Nd:YAG laser (1,064 nm). The treatment success and side effects were evaluated according to objective and subjective parameters, including hemangioma thickness measured by ultrasound and the parents' evaluation of treatment. RESULTS All 77 treated IH responded to the therapy, of which 52.8 % healed after the end of treatment and 47.2 % had only minimum residual components. The success of treatment was assessed by the parents in 92.6 % as very good or good. Transient blistering occurred as the main side effect in 45.9 %. CONCLUSIONS Combination therapy with PDL and Nd:YAG laser represents an effective local method for IH with minimal side effects.
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Affiliation(s)
- Kjell M Kaune
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Germany; Dermatology and Allergology, Klinikum Bremen-Mitte, Bremen, Germany
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Su W, Ke Y, Xue J. Beneficial effects of early treatment of infantile hemangiomas with a long-pulse Alexandrite laser. Lasers Surg Med 2014; 46:173-9. [PMID: 24391080 DOI: 10.1002/lsm.22221] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE There is an increasing interest in treating vascular lesions with a long-pulse Alexandrite laser. However, it is difficult to search information in the literature about infantile hemangiomas (IH) treated with long-pulse Alexandrite laser. This article aims to determine whether 755 nm long-pulse Alexandrite laser is effective and safe for early intervention of IH and provides some new data on this issue. MATERIALS AND METHODS This is a retrospective study of 48 infants with IH treated with long-pulse Alexandrite laser during a 1.5-year period. Patients received a series of 1-7 treatment sessions with long-pulse Alexandrite laser at settings of 3 milliseconds pulse duration, 6-8 mm spot, 45-70 J/cm(2) fluences, and with dynamic cooling device (DCD) spray duration of 90 milliseconds and delay of 80 milliseconds, given at 4- to 6-week intervals. RESULTS This study demonstrated that IH responded favorably to the treatment of a long-pulse Alexandrite laser while accompany with relatively few complications. The difference between the original untreated and post-treatment scores of all IH and two subgroups were statistically significant, respectively (P < 0.01). The difference of the degree of improvement between the two subgroups was not significant (P > 0.05). It was observed that IH on the trunk and extremities improved more effectively and more quickly than those on the face, neck, and perineum. Besides, age at the first treatment, the sex of the patients and the presence of proliferation were not significantly correlated with the degree of improvement. Adverse effects were seen in 11 patients (22.91%): blistering (n = 9), marked edema and erosion without subsequent residual scarring (n = 1), and hypopigmentation (n = 1), which improved gradually with time. Fortunately, there was no incidence of scarring or ulceration in this case series of IH. CONCLUSIONS It was clinically effective and safe for early treatment of IH, including the thick/deep ones, with a long-pulse Alexandrite laser, which indicated be able to reduce the possibility that the IH will reach its full size. In this way it can prevent several complications connected to the rapid proliferation of IH.
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Affiliation(s)
- Wenting Su
- Department of Dermatology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou Children's Hospital, Wenzhou, 325027, Zhejiang Province, China
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Alcántara-González J, Boixeda P, Truchuelo-Díez M, Pérez-García B, Alonso-Castro L, Jaén Olasolo P. Infantile Hemangiomas Treated by Sequential Application of Pulsed Dye Laser and Nd:YAG Laser Radiation: A Retrospective Study. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.adengl.2012.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Alcántara-González J, Boixeda P, Truchuelo-Díez MT, Pérez-García B, Alonso-Castro L, Jaén Olasolo P. Infantile hemangiomas treated by sequential application of pulsed dye laser and Nd:YAG laser radiation: a retrospective study. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:504-11. [PMID: 23522740 DOI: 10.1016/j.ad.2012.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 12/17/2012] [Accepted: 12/25/2012] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Infantile hemangiomas are the most common benign tumor in children. They have 3 phases of development: a proliferative phase, an involuting phase, and involution. Although active treatment is often not required, it is necessary in some cases. Of the possible treatments for hemangiomas, lasers have been shown to be effective in all phases of development. We report our experience with dual-wavelength sequential pulses from a pulsed dye laser and an Nd:YAG laser. MATERIAL AND METHODS This was a retrospective, descriptive study of patients with infantile hemangioma in different phases of development treated with pulsed dye laser pulses followed by Nd:YAG laser pulses. Four dermatologists assessed the effectiveness of treatment on a scale of 10 to 0. Adverse effects and incidents related to treatment were recorded. The median and interquartile range were calculated as descriptive statistics. Pretreatment and posttreatment comparisons were performed using the Wilcoxon test. RESULTS Twenty-two patients with hemangiomas in different phases of development were included. A statistically significant improvement was obtained both for the entire group and for different subgroups. Posttreatment events were reported in 4 patients, and included edema and ulceration, skin atrophy, and hyperpigmentation. CONCLUSIONS We believe that treatment with dual-wavelength light from a pulsed dye laser and a Nd:YAG laser is a viable treatment option for infantile hemangiomas when first-line therapies are ineffective or contraindicated.
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França K, Chacon A, Ledon J, Savas J, Izakovic J, Nouri K. Lasers for cutaneous congenital vascular lesions: a comprehensive overview and update. Lasers Med Sci 2012; 28:1197-204. [DOI: 10.1007/s10103-012-1220-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 10/15/2012] [Indexed: 12/20/2022]
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Chen D, Xia R, Corry PM, Moros EG, Shafirstein G. SonoKnife for ablation of neck tissue: in vivo verification of a computer layered medium model. Int J Hyperthermia 2012; 28:698-705. [PMID: 22946601 DOI: 10.3109/02656736.2012.706730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study aimed to determine which treatment parameters of the SonoKnife device can be used to safely and effectively perform non-invasive thermal ablation of subcutaneous tissue. METHODS A three-dimensional computational layered medium model was constructed to simulate thermal ablation treatment of the SonoKnife device. The acoustic and thermal fields were calculated with the Fast Object-Oriented C++ Ultrasound-Simulator software and a finite difference code, respectively. Subcutaneous tissue was represented as layers of skin, fat and muscle. The simulations were conducted for ultrasound frequencies of 1 or 3.5 MHz. The thermal dose model was used to predict the size and location of the ablated regions. The computer simulations were verified by using the SonoKnife to perform subcutaneous ablations in the neck area of healthy pigs, in vivo. Triphenyltetrazolium chloride viability stain was used to differentiate viable tissue from ablated regions ex vivo. RESULTS The simulations for the layered medium model suggest that operating the SonoKnife at frequency of 1 MHz is more effective and safer than 3.5 MHz providing skin cooling is applied prior to ablation. These predictions were in agreement with the results observed in the animal studies. The required sonication time for ablation increased from 50 to 300 s by using 1 MHz. CONCLUSION Our modelling and animal studies suggest that 1 MHz with pretreatment skin cooling are the optimal settings to operate the SonoKnife to safely and effectively perform subcutaneous thermal ablation of porcine skin. More work is needed to optimise skin cooling and define the optimal sonication time.
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Affiliation(s)
- Duo Chen
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Miyazaki H, Ohshiro T, Watanabe H, Kakizaki H, Makiguchi T, Kim M, Negishi A, Yokoo S. Ultrasound-guided intralesional laser treatment of venous malformation in the oral cavity. Int J Oral Maxillofac Surg 2012; 42:281-7. [PMID: 22835683 DOI: 10.1016/j.ijom.2012.06.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 04/20/2012] [Accepted: 06/15/2012] [Indexed: 11/18/2022]
Abstract
An ultrasound-guided intralesional photocoagulation (ILP) technique using a laser is described for treatment of deep venous malformations in the oral cavity. ILP is basically a blind operation and has a risk of unintended destruction of surrounding normal tissue, therefore the authors now routinely use guidance by ultrasonography using a mini-probe to improve the safety and reliability of ILP. This approach enables safe fibre insertion, appropriate laser irradiation, and intraoperative assessment of coagulation. The use of this technique is described in 8 patients. The authors conclude that ultrasound-guided ILP with a laser is a promising technique for less-invasive treatment of a vascular malformation in the oral cavity.
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Affiliation(s)
- H Miyazaki
- Department of Stomatology and Oral Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.
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Laser Treatment of Cutaneous Vascular Tumors and Malformations. Facial Plast Surg Clin North Am 2011; 19:303-12. [PMID: 21763991 DOI: 10.1016/j.fsc.2011.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Civas E, Koc E, Aksoy B, Aksoy HM. Clinical Experience in the Treatment of Different Vascular Lesions Using a Neodymium-Doped Yttrium Aluminum Garnet Laser. Dermatol Surg 2009; 35:1933-41. [DOI: 10.1111/j.1524-4725.2009.01355.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cassuto D, Mollia JF, Scrimali L, Sirago P. Right-left comparison study of hydrogel pad versus transparent fluid gel in patients with dermo-cosmetic lesions undergoing non-ablative laser therapy. J COSMET LASER THER 2009; 11:45-51. [PMID: 19204845 DOI: 10.1080/14764170802663169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to compare the cooling properties of a transparent hydrogel pad and a fluid gel in patients with dermo-cosmetic lesions undergoing non-ablative laser therapy. METHODS Patients enrolled in this prospective, open, randomized study had vascular or pigmented lesions in the face, v-neck or hands. The assigned test product was applied to the skin on the left side of the lesion whereas the other product was applied to the opposite side. Primary endpoints were the maximal pain intensity during laser treatment and the number of blisters and crusts after laser treatment. RESULTS Twenty-one patients were enrolled and underwent laser procedures using a hydrogel pad and fluid gel (16 patients with vascular and five with pigmented lesions). Maximal local pain severity was lower in all 21 patients on the side where the transparent hydrogel pad was applied (p<0.001); the transparent hydrogel pad was associated with a more cooling effect (p<0.001) and less erythema (p = 0.027). The number of crusts was similar for both test products. CONCLUSION Overall, laser therapy was more convenient for the patients on the side where the transparent hydrogel pad was applied. The transparent hydrogel pad offers an alternative skin cooling method worth considering for non-ablative laser therapy.
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Miyazaki H, Kato J, Watanabe H, Harada H, Kakizaki H, Tetsumura A, Sato A, Omura K. Intralesional laser treatment of voluminous vascular lesions in the oral cavity. ACTA ACUST UNITED AC 2008; 107:164-72. [PMID: 18930663 DOI: 10.1016/j.tripleo.2008.08.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Revised: 07/16/2008] [Accepted: 08/09/2008] [Indexed: 11/27/2022]
Abstract
OBJECTIVE In laser treatment of voluminous vascular lesions, there are many cases in which submucosally located angioma remnants cannot be reached by noncontact superficial laser application. To diminish these remnants we used intralesional photocoagulation (ILP) in treatment of oral vascular lesions, because this approach is effective in treatment of voluminous vascular lesions of the skin. STUDY DESIGN Four cases of voluminous vascular malformation in the oral cavity were treated by ILP using a potassium-titanyl-phosphate (KTP) laser. In 1 case, treatment was carried out under ultrasound and manual control. RESULTS All lesions showed more than 70% regression after the first ILP session, and the treatment outcome was satisfactory. There were no serious complications, such as bleeding or invasive infection. Ultrasonography was useful for guiding laser treatment in the oral cavity. CONCLUSION Intralesional photocoagulation treatment with a KTP laser is effective and safe for treatment of a vascular lesion in the oral cavity.
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Affiliation(s)
- Hidetaka Miyazaki
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
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Handley JM. Adverse events associated with nonablative cutaneous visible and infrared laser treatment. J Am Acad Dermatol 2006; 55:482-9. [PMID: 16908355 DOI: 10.1016/j.jaad.2006.03.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Revised: 03/08/2006] [Accepted: 03/14/2006] [Indexed: 11/26/2022]
Abstract
Since the theory of selective thermolysis was developed in the early 1980s, there have been numerous advances in both laser technology and the understanding of laser-tissue interaction. Nonablative dermatologic treatments involving laser light continue to be increasingly used for a number of diverse applications such as skin remodeling, the treatment of cutaneous melanocytic and vascular lesions, and the removal of undesired hair and tattoo pigment. Although these techniques are regarded as safe, both temporary and permanent adverse reactions do occur, many of which are thermally mediated. Little has been published on the frequency of adverse events in nonablative cutaneous laser treatments, or on the comparative efficacy of the various strategies commonly used to minimize them. Through reviewing relevant publications from the last 5 years, this article will address both these issues.
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Affiliation(s)
- Julian M Handley
- Bloomfield Laser and Cosmetic Surgery Centre, Bangor, Northern Ireland, United Kingdom.
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Vlachakis I, Arbiros I, Velaoras K, Charissis G. Different Modes Cooling the Epidermis with Ice during Nd:YAG Laser Treatment of Hemangiomas in Children. ACTA ACUST UNITED AC 2004. [DOI: 10.1078/1615-1615-00120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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