Abstract
Vascular pathology in the head and neck is commonly diagnosed and treated by the maxillofacial surgeons. While surgery has been the primary mode of therapy, alternatives as well as adjunctive therapies such as laser, radiographic-guided embolization, and various types of medications can also be used in the management of vascular anomalies. This chapter focuses on the various laser modalities currently available in the market, and their indications for use in different types of vascular pathology. The primary advantage of using laser therapy lies in the ability to selectively target and destroy abnormal tissues, while sparing and minimizing destructions to adjacent normal tissues. For their purpose, laser therapy allows for predictable results, efficiency, and often a smoother postoperative recovery for the patients. Like any other treatment approaches in pathology, understanding the mechanism of laser therapy is the key in correctly selecting the type of laser for a particular vascular lesion. This chapter will conclude by circling back to describing the most common vascular anomalies in the head and neck region and available adjunctive treatments to both laser and surgical therapies.
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References
Geiges ML. History of lasers in dermatology. In: Basics in dermatological laser applications, vol. 42. Basel: Karger Publishers; 2011. p. 1–6.
Waldorf HA, Lask GP, Geronemus RG. Laser treatment of telangiectasias. In: Cosmetic laser surgery. New York, NY: Wiley; 1996. p. 71–107.
Ng MSY, Tay YK. Laser treatment of infantile hemangiomas. Indian J Paediatr Dermatol. 2017;18(3):160.
Jasim ZF, Woo WK, Handley JM. Long-pulsed (6-ms) pulsed dye laser treatment of rosacea-associated telangiectasia using subpurpuric clinical threshold. Dermatol Surg. 2004;30(1):37–40.
Dierickx CC, Casparian JM, Venugopalan V, Farinelli WA, Anderson RR. Thermal relaxation of port-wine stain vessels probed in vivo: the need for 1-10-millisecond laser pulse treatment. J Invest Dermatol. 1995;105(5):709–14.
Lorenz S, Scherer K, Beatrix Wimmershoff M, Landthaler M, Hohenleutner U. Variable pulse frequency-doubled Nd: YAG laser versus flashlamp-pumped pulsed dye laser in the treatment of port wine stains. Acta Derm Venereol. 2003;83(3):210.
Clymer MA, Fortune DS, Reinisch L, Toriumi DM, Werkhaven JA, Ries WR. Interstitial Nd: YAG photocoagulation for vascular malformations and hemangiomas in childhood. Arch Otolaryngol Head Neck Surg. 1998;124(4):431–6.
Vesnaver A, Dovšak DA. Treatment of large vascular lesions in the orofacial region with the Nd: YAG laser. J Craniomaxillofac Surg. 2009;37(4):191–5.
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(12):1933–41.
Groot D, Rao J, Johnston P, Nakatsui T. Algorithm for using a long-pulsed Nd: YAG laser in the treatment of deep cutaneous vascular lesions. Dermatol Surg. 2003;29(1):35–42.
Yang HY, Zheng LW, Yang HJ, Luo J, Li SC, Zwahlen RA. Long-pulsed Nd: YAG laser treatment in vascular lesions of the oral cavity. J Craniofac Surg. 2009;20(4):1214–7.
Frame JW. Removal of oral soft tissue pathology with the CO2 laser. J Oral Maxillofac Surg. 1985;43(11):850–5.
Strauss RA, Fallon SD. Lasers in contemporary oral and maxillofacial surgery. Dent Clin North Am. 2004;48(4):861–88.
Zaffe D, Vitale MC, Martignone A, Scarpelli F, Botticelli AR. Morphological, histochemical, and immunocytochemical study of CO2 and Er: YAG laser effect on oral soft tissues. Photomed Laser Surg. 2004;22(3):185–9.
Niamtu J III. The treatment of vascular and pigmented lesions in oral and maxillofacial surgery. Oral Maxillofac Surg Clin North Am. 2004;16(2):239–54.
Amaral MBF, De Ávila JMS, Abreu MHG, Mesquita RA. Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial. Int J Oral Maxillofac Surg. 2015;44(11):1383–9.
Stratigos AJ, Dover JS, Arndt KA. Laser therapy. Dermatology. 2003;2:2153–75.
Landthaler M, Hohenleutner U. Laser therapy of vascular lesions. Photodermatol Photoimmunol Photomed. 2006;22(6):324–32.
Tomson N, Lim SPR, Abdullah A, Lanigan SW. The treatment of port-wine stains with the pulsed-dye laser at 2-week and 6-week intervals: a comparative study. Br J Dermatol. 2006;154(4):676–9.
Anolik R, Newlove T, Weiss ET, Brightman L, Hale EK, Karen JK, et al. Investigation into optimal treatment intervals of facial port-wine stains using the pulsed dye laser. J Am Acad Dermatol. 2012;67(5):985–90.
Orten SS, Waner M, Flock S, Roberson PK, Kincannon J. Port-wine stains: an assessment of 5 years of treatment. Arch Otolaryngol Head Neck Surg. 1996;122(11):1174–9.
Savas JA, Ledon JA, Franca K, Chacon A, Nouri K. Pulsed dye laser-resistant port-wine stains: mechanisms of resistance and implications for treatment. Br J Dermatol. 2013;168(5):941–53.
Stier MF, Glick SA, Hirsch RJ. Laser treatment of pediatric vascular lesions: port wine stains and hemangiomas. J Am Acad Dermatol. 2008;58(2):261–85.
Ronchese F. The spontaneous involution of cutaneous vascular tumors. Am J Surg. 1953;86(4):376–86.
Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg. 1983;18(6):894–900.
David LR, Malek MM, Argenta LC. Efficacy of pulse dye laser therapy for the treatment of ulcerated haemangiomas: a review of 78 patients. Br J Plast Surg. 2003;56(4):317–27.
Cao Y, Wang F, Jia Q, Xu R, Dang W, Chen Q, Wang Y. One possible mechanism of pulsed dye laser treatment on infantile hemangioma: induction of endothelial apoptosis and serum vascular endothelial growth factor (VEGF) level changes. J Lasers Med Sci. 2014;5(2):75.
Reddy KK, Blei F, Brauer JA, Waner M, Anolik R, Bernstein L, Geronemus RG. Retrospective study of the treatment of infantile hemangiomas using a combination of propranolol and pulsed dye laser. Dermatol Surg. 2013;39(6):923–33.
Asilian A, Mokhtari F, Kamali AS, Abtahi-Naeini B, Nilforoushzadeh MA, Mostafaie S. Pulsed dye laser and topical timolol gel versus pulse dye laser in treatment of infantile hemangioma: a double-blind randomized controlled trial. Adv Biomed Res. 2015;4:257.
Park KH, Jang YH, Chung HY, Lee WJ, Kim DW, Lee SJ. Topical timolol maleate 0.5% for infantile hemangioma; it’s effectiveness and/or adjunctive pulsed dye laser–single center experience of 102 cases in Korea. J Dermatol Treat. 2015;26(4):389–91.
Wall TL. Current concepts: laser treatment of adult vascular lesions. Semin Plast Surg. 2007;21(3):147.
Feldman SR, Huang WW, Huynh TT. Current drug therapies for rosacea: a chronic vascular and inflammatory skin disease. J Manag Care Pharm. 2014;20(6):623–9.
Weinkle AP, Doktor V, Emer J. Update on the management of rosacea. Clin Cosmet Investig Dermatol. 2015;8:159.
Tanghetti E, Sherr E. Treatment of telangiectasia using the multi-pass technique with the extended pulse width, pulsed dye laser (Cynosure V-Star). J Cosmet Laser Ther. 2003;5(2):71–5.
Iyer S, Fitzpatrick RE. Long-pulsed dye laser treatment for facial telangiectasias and erythema: evaluation of a single purpuric pass versus multiple subpurpuric passes. Dermatol Surg. 2005;31(8):898–903.
Solak B, Sevimli Dikicier B, Oztas Kara R, Erdem T. Single-center experience with potassium titanyl phosphate (KTP) laser for superficial cutaneous vascular lesions in face. J Cosmet Laser Ther. 2016;18(8):428–31.
Cassuto DA, Ancona DM, Emanuelli G. Treatment of facial telangiectasias with a diode-pumped Nd: YAG Laser at 532nm. J Cutan Laser Ther. 2000;2(3):141–6.
Alam M, Dover JS, Arndt KA. Treatment of facial telangiectasia with variable-pulse high-fluence pulsed-dye laser: comparison of efficacy with fluences immediately above and below the purpura threshold. Dermatol Surg. 2003;29(7):681–5.
Boon LM, Mulliken JB, Enjolras O, Vikkula M. Glomuvenous malformation (glomangioma) and venous malformation: distinct clinicopathologic and genetic entities. Arch Dermatol. 2004;140(8):971–6.
Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies. Curr Prob Surg. 2000;37(8):517–84.
Scolozzi P, Laurent F, Lombardi T, Richter M. Intraoral venous malformation presenting with multiple phleboliths. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(2):197–200.
Glade R, Vinson K, Richter G, Suen JY, Buckmiller LM. Endoscopic management of airway venous malformations with Nd: YAG laser. Ann Otol Rhinol Laryngol. 2010;119(5):289–93.
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Tran, H.Q., Manon, V.A., Young, S., Melville, J.C. (2022). Lasers and Nonsurgical Modalities. In: Nair, S.C., Chandra, S.R. (eds) Management of Head and Neck Vascular Lesions. Springer, Singapore. https://doi.org/10.1007/978-981-15-2321-2_10
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DOI: https://doi.org/10.1007/978-981-15-2321-2_10
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