Surgical resection of a large hypopharyngeal hemangioma in an adult using neodymium-doped yttrium aluminum garnet laser: A case report

BACKGROUND Generally,hemangiomas do not require surgical intervention;however,cases of large hemangiomas,potentially involving the throat and trachea,necessitate surgical therapy.Here,we present a case of hypopharyngeal hemangioma in an adult that was successfully treated with neodymium-doped yttrium aluminum garnet(Nd-YAG)laser.CASE SUMMARY Laryngoscopic examination of a 61-year-old man demonstrated the presence of a large,submucosal vascular lesion that extended into the epiglottis,left arytenoid cartilage,lateral to the aryepiglottic fold,and pyriform sinus.The lesion was resected and photocoagulated with limited hemorrhage using Nd:YAG laser.The hypopharyngeal hemangioma was completely excised.The patient showed no recurrence of hypopharyngeal hemangioma during the 1.5-year follow-up period.CONCLUSION Laser therapy is one of the effective tools for treating hemangiomas with rapid,uncontrolled growth or in functional areas,with few side effects and complications.The present case of a male patient with a large hypopharyngeal hemangioma,treated with YAG laser,demonstrates the efficacy of laser photocoagulation in treating cases of hemangiomas,without the risk of bleeding or airway obstruction.The favorable postoperative outcomes demonstrated by our patient with Nd:YAG laser therapy indicate its consideration in the therapy of similar cases.     

Ultrasound-Navigated Interstitial Nd:YAG LaserCoagulation of Congenital Vascular Disorders

The treatment of voluminous hemangiomas or vascular malformations, particularly of the infiltrative type, is difficult and requires a combination of methods such as surgical excision, embolisation, laser therapy, sclerotherapy and magnesium spiking. The goal of this study was to investigate the efficacy of ultrasound-navigated interstitial Nd:YAG (Neodymium:Yttrium-Aluminium-Garnet) laser coagulation of hemangiomas and vascular malformations.Ultrasound-navigated interstitial Nd:YAG laser coagulation was performed on 21 patients with cavernous hemangiomas or vascular malformations. 12 patients had vascular malformations primarily of the venous kind, whereas arteriovenous components were predominant in 5 patients. In 4 children, an extensive hemangioma was the indication for interstitial laser therapy. Laser energy with a power of 7–10 W was applied via puncture canula through a 600 μm glass fiber and with support of ultrasound guided to the vessel wall. Immediately after laser application the blood flow was controlled with color-coded duplexsonography.Three months after lasertreatment, a volume reduction between 60% and 80% in hemangiomas (n = 4), between 20% and 70% in venous malformations (n = 12) and 0% to 70% in arteriovenous malformations (n = 5) was achieved. With exception of necrosis in one patient which healed spontaneously, no further complications occurred.Ultrasound-navigated interstitial Neodym-YAG-laser coagulation is an effective and minimally invasive method for treating voluminous hemangiomas and vascular malformations and is an alternative or complimentary to other therapies.     

长脉冲1 064 nm Nd：YAG激光治疗婴幼儿皮肤血管瘤60例疗效研究

目的:观察长脉冲1064 nm Nd:YAG激光治疗婴幼儿皮肤血管瘤的临床疗效。方法:随机抽取我院2013年12月~2014年11月收治的60例皮肤血管瘤患儿作为研究对象,均采用长脉冲1064 nm Nd:YAG激光对60例患儿实施治疗,观察60患儿的临床治疗效果和不良反应情况。结果:60例患儿的临床治疗总有效率为96.7%。鲜红斑痣、单纯性血管瘤、混合型血管瘤患儿的临床治疗总有效率分别为94.4%、100.0%和90.0%;60例患儿的不良反应发生率为5.0%。结论:采用长脉冲1064 nm Nd:YAG激光对皮肤血管瘤患儿实施治疗,不良反应少,疗效确切。     

The Nd:YAG laser treatment of hemangioma

An Nd:YAG laser was used in the treatment of 160 patients with hemangioma from January 1989 to January 1993. Irradiance was between 800 and 1600 W/cm 2 with energy between 400 and 1600 J/cm 2. The best results with almost total restoration were obtained in 21 of the 160 patients (13%). The size of the hemangioma was reduced by more than 50% in 88 cases (55%), by less than 50% in 56 cases (35%), and by a negligible amount in 3 cases (2%). Side effects as found in 160 patients or 10% included slow healing, superficial skin necrosis, and occurrence of scars. Most hemangiomas can shrink by themselves. However, the treatment is needed for cases with risk of various side effects including scar formation, sepsis, bleeding, or abnormal growth of an organ. We concluded that the Nd:YAG laser is a very useful instrument in the treatment of abnormality of blood vessels, such as hemangioma.     

The use of high-power lasers in oral surgery

This study describes the treatment of 2989 patients with different type of lasers. The argon laser beam was used in 57 cases for procedures ranging from portwine stains, telangiectasias, and angiofibromas to other vascular lesions. Eighty-four operations including treatment of leukoplakia and hemangioma were performed using the Nd YAG laser. An additional 53 operations were performed using the combined Nd:YAG laser beam and 2795 operations were done using the carbon dioxide laser on precancerous states and other white lesions, benign tumors and tumor-like states, malignant tumors, and other lesions. The laser procedures were performed under local anesthesia. Operations were rapid and bloodless yielding both excellent cosmetic and functional results. The experience gained with this group of patients suggests that the ideal cases for laser treatment were leukoplakia, hemangiomas, and other vascular tumors and lesions of the face and the oral cavity, and clotting disturbance.     

Nd:YAG and CO2 laser therapy of oral mucosal lesions

OBJECTIVE: Experiences gained in the management of oral mucosal lesions by CO2 and Nd:YAG laser therapy in an outpatient clinic treated over an 80-year period are described. SUMMARY BACKGROUND DATA: Lasers have indications for use in dentistry for incision, excision, and coagulation of intraoral soft tissue. Advances in laser technology have provided delivery systems for site-specific delivery of laser energy with short interaction items on tissue to be ablated. This study retrospectively evaluates a series of clinical case studies. METHODS: Sixty-four patients with a variety of benign oral soft tissue lesions were treated by laser excision. Thirty-five patients were treated by a pulsed fiberoptic delivered Nd:YAG contact laser, and 29 by a continuous free-beam CO2 non-contact laser. The largest group of lesions treated were leukoplakia (39 cases). Other lesions excised and biopsied were lichen planus, squamous papilloma, pyogenic granuloma, focal melanosis, nonhealing traumatic ulceration, hemangioma, and lymphangioma. All patients were followed postoperatively (mean 6.8 months, range 1-36 months). RESULTS: Laser excision was well tolerated by patients with no intraoperative or postoperative adverse effects. All patients healed postsurgically with no loss of function. CONCLUSIONS: CO2 and Nd:YAG lasers are successful surgical options when performing excision of benign intraoral lesions. Advantages of laser therapy include minimal postoperative pain, conservative site-specific minimally invasive surgeries, and elimination of need for sutures.     

可调脉宽倍频ND∶YAG激光治疗皮肤血管性疾病的疗效分析

目的　观察可调脉宽倍频ND :YAG激光治疗血管性疾病的临床疗效与治愈次数和不良反应。方法　用可调脉宽倍频ND :YAG 5 3 2nm激光治疗 115 9例皮肤血管性疾病 ,包括鲜红斑痣、草莓状血管瘤、静脉 (动脉性 )血管瘤、血管角化瘤、毛细血管扩张和蜘蛛痣。结果　治疗静脉 (动脉性 )血管瘤、草莓状血管瘤、血管角化瘤有效率均达到 85 %以上 ,蜘蛛痣为 81 2 %,毛细血管扩张为 70 9%,鲜红斑痣为 48 0 %。结论　可调脉宽倍频ND :YAG 5 3 2nm激光治疗静脉 (动脉性 )血管瘤、草莓状血管瘤、血管角化瘤及蜘蛛痣、毛细血管扩张等血管性疾病效果较好 ,治疗鲜红斑痣效果略差。治疗时能量密度过高有可能留有瘢痕     

Interstitial Laser Treatment of Venous Malformations

Objective: Venous malformations are aside from hemangiomas the most common vascular lesions observed in the pediatric age group. While interstitial Nd:YAG laser treatment was first used to treat hemangiomas in infancy, the mechanism of this treatment also can be used for venous malformations to reduce bulk and hypervascularisation, and improve contour and function.Study design: We reviewed our experience with the use of interstitial Nd:YAG laser therapy in treating complicated venous or mixed malformations. The lesions reported were particular troublesome because of significant cosmetic disfigurement, maceration or ulceration, bleeding, coagulopathy, painful swelling, and of potential functional impairment. During a 15-year period, 176 patients with predominantly venous malformations were treated by interstitial Nd:YAG laser treatment, and 157 of the 176 patients were treated additionally by transcutaneous Nd:YAG laser treatment with local ice cube cooling to protect the overlying skin. By using interstitial laser treatment, the laser beam was transmitted using a 0.6 mm bare fiber that was placed through an 16G abbocath into the lesion to be treated. The laser energy ranged from 5 W to 8 W in continuous mode. Color-coded duplex sonography was used for monitoring the procedure. Treatments were done under general anesthesia.Results:Overall, excellent results were achieved in 43% of patients and good results occured in 52%. In 5% treatment was deemed to have failed. Complications included paresthesia, dysesthesia, mild trismus, and local motoric plegia. All complications were transient and disappeared completely. Overall, satisfaction was high because of clear reduction of complaints, and all but 1 patient would have laser treatment again.Conclusions: On the base of our results we conclude that interstitial Nd:YAG laser treatment may successfully prevent enlargement and promote improvement with flattening of the lesion, less swelling, and improvement in the vascular red or bluish hue with minimal adverse effects.     

Nd:YAG激光和Er:YAG激光联合Gluma脱敏剂治疗非手术牙周治疗后牙本质敏感疗效观察

目的 评价Gluma脱敏剂、Nd:YAG激光和Er:YAG激光单独及联合治疗非手术牙周治疗引起的牙本质过敏症(DH)的疗效.方法 选择60例经非手术牙周治疗后发生DH的牙周炎患者,共计180颗患牙.将患牙随机分为6组,每组30颗,其中A组:空白对照组;B组:Gluma脱敏剂组;C组:Nd:YAG激光组;D组:Er:YA...     

Treatment of lymphangioma with Nd:YAG laser irradiation: a case report

OBJECTIVE: In this case report, the treatment of a buccal lymphangioma in a 9-year-old female was done using the Nd:YAG laser and the clinical outcome was evaluated. BACKGROUND DATA: The treatment of lymphangioma with the laser surgery using Nd:YAG and CO2 laser has become favorable due of a lack of postoperative pain and hemorrhage. METHODS: The lesion was treated with a pulsed Nd:YAG laser (d-lase 300, American Dental Laser, Detroit, MI). An exposure of 10 min each was performed at an interval of 10 days by the noncontact method with the energy density of 1 W, 10 Hz. RESULTS: It was observed that there was a great reduction of the lesion and a considerable reduction of the external facial volume. As the excision of the lesion was avoided in our present study, there was no pain and hemorrhage. A remarkable reduction of the tumor size could be observed visually within the five laser exposures. CONCLUSIONS: It can be concluded that if Nd:YAG laser therapy is used for reducing the tumor size as a primary treatment, the operation becomes easy and the recurrence may be less than with the conventional treatment, and an option of a surgical or laser excision could be reserved.     

Different Modes Cooling the Epidermis with Ice during Nd:YAG Laser Treatment of Hemangiomas in Children

We report whether the different modes of cooling with ice the epidermis influence the number of sessions required to treat hemangiomas in children with Nd:YAG laser and ameliorates the cosmetic end result. Between 1993 and 2002 235 children with cutaneous haemangiomas were treated with an Nd:YAG laser. The patients were divided into 2 groups according the mode of cooling the epidermis with ice. The first group contained 115 patients where the epidermis was cooled with ice only during the irradiation. In the second group, contained 120 patients, the epidermis was cooled with ice, prior to, during and after irradiation. The protection of epidermis with ice prior to, during and after irradiation with Nd:YAG laser had better cosmetic results and decreased the number of sessions for treatment, than the epidermis protection only during irradiation.     

高频超声在儿童面部海绵状血管瘤激光治疗中的应用

目的 应用高频超声观察激光治疗儿童面部海绵状血管瘤的疗效。方法，应用高频超声对10例儿童面部皮下海绵状血管瘤的Nd:YAG激光治疗过程进行动态监测。结果 治疗胶肿瘤呈不均匀的低回声，内有较丰富的血液信号；治疗后肿瘤回声增强且较均匀，内部血流信号减少或消失。结论 高频超声作作为激光治疗儿童面税少绵血管瘤术前定位和术后疗效判断的手段。     

光动力疗法与Nd：YAG激光对胃胶原纤维损伤机制的比较

光动力疗法对于胃肠道肿瘤治疗效果令人鼓舞。但有关ＰＤＴ对胃肠道正常组织损伤的研究甚少。探讨了ＰＤＴ与Ｎｄ：ＹＡＧ激光对胃组织损伤的差异。结构发现：Ｎｄ：ＹＡＧ激光治疗过程中光纤周围组织温度明显高于ＰＤＴ组。光镜下二者均可造成明显组织损伤，但二周后修复方式不同，Ｎｄ：ＹＡＧ激光以纤维疤痕组织修复，而ＰＤＴ以正常组织再生修复，电镜发现Ｎｄ：ＹＡＧ激光致胃粘膜下胶原纤维明显损伤。     

Long-pulsed Nd:YAG 1064 nm in the treatment of leg veins: Check up of results at 6 months in 100 patients

This study assessed at 6 months, subjectively and objectively, the efficacy of a long-pulsed Nd:YAG laser system in clearing leg veins.

A hundred female patients (25–60 y.o., skin types II–IV) with leg vein varicosities were treated with single pulse shots by a long-pulsed 1064 nm Nd:YAG laser, with 3, 5, 7 and 10 mm spot size diameters with related energies at 130, 120, 110 and 100 J/cm², and pulse lengths of 20, 30, 40 and 50 ms, respectively.

One or two treatments were given at 2-month intervals, with post-treatment assessments at 6 months. Patients subjectively assessed the treatment and their results were used to identify a satisfaction index (SI). Objective assessment was based on clinical photography and computer-generated data from a vein clearance detection program.

The overall patient satisfaction rate was 57% and objective assessments based on the clinical photography and computer assessment were 64% and 71%, respectively.

The Nd:YAG 1064 nm long-pulsed laser offered efficient treatment of leg veins irrespective of skin phototypes and results were better on blue and thick vessels. Side effects were minimal and transient.     

Separate and combined use of Nd:YAG and carbon dioxide lasers in oral surgery

The experience obtained with 789 laser interventions used in oral surgery is summarized. In the first group, 756 patients were operated on by CO 2 laser, in the second, 17 were treated with Nd:YAG laser, and in the third, 16 were treated simultaneously with both types of lasers. Among the outpatient interventions performed under local anesthesia were 233 precancerous conditions, 491 benign tumours, and 65 other lesions. Following CO 2 laser interventions, the zone of the irreversible tissue damage did not exceed 300 mum in the instance of high energy cutting; it was almost 1 mm following Nd:YAG laser cutting, and it was 500 mum when cut by a combined laser beam. The precancerous conditions can successfully be treated by CO 2 laser, especially by evaporation. The Nd:YAG laser leaves a broad necrotic zone. The combined application, however, is highly advantageous to treat vascular lesions and markedly hemophilic structures/hemangioma, epulis, tongue resection, and so forth. In oral surgery the combined use of the CO 2 and Nd:YAG laser beams is extremely beneficial due to their excellent hemostatic effect.     

长脉冲1064nmNd：YAG激光治疗皮肤血管性疾病

目的探讨应用长脉冲1064nm Nd：YAG激光治疗皮肤血管性疾病的治疗效果。方法自2005年2月至2009年2月,应用长脉冲1064nm Nd：YAG激光治疗皮肤血管性疾病285例,对鲜红斑痣、草莓样血管瘤、混合性血管瘤、皮肤毛细血管扩张、血管痣及充血性增生瘢痕等皮肤血管性疾病,根据皮损的不同性质选定不同能量的光束进行照射,视情况重复治疗1—5次。治疗结束6个月后随访,评价治疗效果。结果285例中,有效245例,有效率为85．9％,治愈153例,治愈率为53．7％,出现色素性改变52例（18．2％）,均在数月至半年后恢复,遗留浅表性瘢痕10例（3．51％）,增生性瘢痕2例（0．7％）。结论长脉冲长脉冲1064nm Nd：YAG激光治疗皮肤血管性疾病具有起效快、疗效显著、不良反应小的优点,具有重要的临床应用价值。     

胆囊形态与胆囊结石相关性的临床研究

目的探讨胆囊形态与胆囊结石形成的相关性。方法分析本院自2005年至2007年对驻地单位40岁以上2230名健康体检者的肝胆超声检查结果,通过统计学处理胆囊形态异常组与胆囊形态正常组患者胆囊结石阳性率。结果胆囊形态异常组与胆囊形态正常组胆结石阳性率均存在统计学差异。结论胆囊形态异常是胆囊结石发病的危险因素。     

Endoscopic Nd:YAG Laser Treatment in the Perioperative Management of Tracheobronchoplasty

The objective of this study was to determine the role of endoscopic Nd:YAG laser treatment in the preoperative or postoperative management of tracheobronchoplasty. Eighteen patients with severe stenotic lesions of the trachea or bronchus underwent Nd:YAG laser treatment. Nd:YAG laser treatment was performed in the preoperative period in 14 patients and in the postoperative period in 4 patients. The indications for Nd:YAG laser treatment included emergency airway dilatation, confirmation of the distal margin of tumor, and safe tracheal intubation in patients with severe tracheal stenosis. The indications for Nd:YAG laser treatment in patients with severe stenosis of the mainstem bronchus were confirmation of the distal margin of tumor and recovery of lung ventilation during the preoperative period and reopening of the bronchial lumen to prevent obstructive pneumonia in the postoperative period. Among patients treated with Nd:YAG laser preoperatively, the indications were completely achieved in all 14 patients, except for 1 patient with adenoid cystic carcinoma who underwent treatment of the right mainstem bronchus. Among patients treated with Nd:YAG laser postoperatively the indications also were achieved in all 4 patients with severe granulomatous stenosis of the bronchial end-to-end anastomosis following sleeve lobectomy. In conclusion, endoscopic Nd:YAG laser treatment played an important role in the perioperative management of patients undergoing tracheobronchoplasty.     

Nd:YAG激光治疗后发性白内障对角膜内皮细胞的影响

目的：观察Nd：YAG激光治疗后发性白内障对角膜内皮细胞的影响。方法：后发性白内障患者21例30只眼,均行Nd：YAG激光治疗,术后用角膜内皮细胞显微镜观察患眼角膜内皮细胞的变化。结果：术后7及14d时患眼中央部位及6点处角膜内皮细胞的各项检测指标与术前比较均无明显变化。结论：2.6-3.2mj能量的Nd：YAG激光治疗后发性白内障对角膜内皮细胞无明显影响。     

Interstitial laser therapy in hemangiomatosis of the liver – A case report

ObjectiveDiffuse neonatal hemangiomatosis (DNH) is a severe disease with multiple organ involvement. If left untreated, it results in high mortality rates. Death occurs due to intractable heart failure following arteriovenous shunting or due to massive cerebral or gastrointestinal bleeding. If there are large liver hemangiomas and medical treatment is not sufficient, it is necessary to use interventional or surgical procedures such as embolization or ligation of the hepatic artery. We present another local tumor destruction procedure to treat liver hemangiomas in DNH, the interstitial laser therapy (ILT).MethodILT was performed in a 3-month-old male infant suffering from DNH with intractable heart failure and multiple liver hemangiomas. Due to the severity of the infant's condition and the minimally invasive character of the treatment, the ILT was performed directly in the neonatal intensive care unit. The ILT was carried out percutaneously by guiding a bare fiber (0.6 mm core diameter) via a puncture needle into the pathologically altered liver region. A Nd:YAG laser (1064 nm) was used as a light source for ILT because its light penetrates deeply into biological tissue. Tissue destruction was achieved with moderate laser power of 4–6 W and a long application time of 90–300 s. Using these applied physical laser parameters, almost spherical volumes of coagulation necrosis could be obtained with diameters of up to 1–2 cm. Puncture and the laser application were monitored by color-coded duplex sonography (CCDS). A decrease in color signal intensity at the tip of the bare fiber indicated the increasing tissue coagulation during application time.ResultsAfter 2 sessions of ILT of liver manifestation in 10 days the cardiac output was reduced by 50%. Postoperative Doppler imaging showed fibrosis in the treated areas of the liver. The child was transferred back to his country of origin but he died 3 months later of intracranial bleeding.ConclusionIn our opinion interstitial laser therapy can be an effective minimally invasive method to treat life-threatening liver hemangiomas in diffuse neonatal hemangiomatosis.