Indications of potassium titanyl phosphate laser therapy for slow-flow vascular malformations in oral region
Indications of potassium titanyl phosphate laser therapy for slow-flow vascular malformations in oral region
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磷酸氧钛钾激光治疗口腔慢流血管畸形的适应证
DOI：
10.1097/scs.0000000000003445
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发表时间：
2017
影响因子：
0.9
通讯作者：
Chikazu D
中科院分区：
文献类型：
--
作者：
Abukawa H;Kono M;Hamada H;Okamoto A;Satomi T;Chikazu D
背景：口腔颌面部慢血流血管畸形的激光治疗适应症尚未有明确的文献记载。作者旨在估计慢流血管畸形的消退频率，并确定与磷酸钛酸钾（KTP）激光治疗中消退相关的风险和预后因素。方法：本研究采用前瞻性队列研究。诊断为慢血流血管畸形的患者连续接受KTP激光治疗。所有患者均在局麻下行病灶内激光光凝。在所有患者的整个手术过程中，KTP激光的给药功率固定在2瓦。主要目的是了解激光治疗慢血流血管畸形的频率。次要终点是：基于病变大小的治疗结果；基于地点的治疗结果；治疗结果基于以焦耳为单位的总能量；并发症的类型。治疗结果通过临床评估和磁共振成像上病变大小的减少来判断。结果：26例患者（男9例，女17例）38个病灶。平均病灶大小为13.5±7.7 mm。基于病灶大小的治疗结果显示，在小于30mm的病灶中获得治愈和消退。然而，大于30mm的病变没有反应。舌头和嘴唇的病变比其他部位的治愈率更高。基于以焦耳为单位的总能量的治疗结果显示，68%的病变在低于400焦耳的情况下得到治疗并反应良好。口腔黏膜病变的并发症发生率较高。术后即刻并发症如坏死在高能组比低能组更常见。结论：KTP激光治疗小于30mm的慢血流性血管畸形疗效显著，且无明显副作用。
Background:Indications for laser therapy for slow-flow vascular malformations in the oral and maxillofacial regions have not been clearly documented. The authors aimed to estimate the frequency of resolution of slow-flow vascular malformations and to identify risk and prognostic factors associated with resolution in potassium titanyl phosphate (KTP) laser treatment.Methods:This study was designed as a prospective cohort study. Patients who had diagnosed slow-flow vascular malformations were continuously assigned to receive KTP laser therapy. All patients had intralesional laser photocoagulation performed under local anesthesia. Administered power of the KTP laser was fixed at 2 watts throughout the procedure in all patients. The primary endpoint was to understand the frequency of resolution of slow-flow vascular malformations in KTP laser treatment. Secondary endpoints were: treatment outcomes based on lesion size; treatment outcomes based on location; treatment outcomes based on total energy in joules; types of complications. Treatment outcomes were judged by a clinical assessment as well as reduction in lesion size on magnetic resonance imaging.Results:Data were obtained from 26 patients (9 men, 17 women) with 38 lesions. The average lesion size was 13.5±7.7 mm. Treatment outcomes based on lesion size showed that cure and regression were obtained in lesions less than 30 mm in size. However, lesions larger than 30 mm showed no response. Lesions in the tongue and lips showed higher cure rates than in other areas. Treatment outcomes based on administered total energy in joules showed that 68% of lesions were treated and responded well at less than 400 joules. Complication rate was relatively high in the buccal mucosal lesions. Immediate postoperative complications such as necrosis were more common in high-energy administration than in low-energy administration.Conclusion:Our results indicated that KTP laser therapy was effective for slow-flow vascular malformations less than 30 mm in size without significant side effects.