Treatment of lymphangioma with CO2 laser in the mandibular alveolar mucosa

Abstract

Objective: In this case report, treatment of lymphangioma (a red-purple vesicular apperance, nonulcerated lesion, located on the gingiva of the mandibular alveolar bone) with CO2 laser on a 63-year-old female patient and 2 years clinical outcome is presented.

Background: Lymphangiomas are hemorrhagic, rare, benign hamartomatous tumors of lymphatic system have a marked predilection for the head, neck and oral cavity. Lymphangiomas are congenital lesions and an often present at or around the time of birth (60%). Among the dental laser systems, CO2 laser is the most suitable instrument for the treatment of soft tissue pathologies because of its affinity for water-based tissues. The absorbed energy causes vaporization of the intra- and extracellular fluid and destruction of the cell membranes. A major advantage of the 10.600 nm wavelength CO2 laser is its ability to seal blood vessels during surgery and to make the excision of vascular lesions with its hemostatic effect.

Methods: CO2 laser application (focused CO2 laser beam, 10.600 nm) was performed in a separate operation room at 3 watt (W), continous wave (CW) with 90 degree angle tip under local anesthesia. The mouth was protected from reflection of the laser by wet gauzes. The wound formed by laser was left open to secondary epithelization. Excessive bleeding was not observed during the procedure. The wound formed by laser was left open to secondary epithelization. Neither sutures nor dressings were used after surgery. Only paracetamol and chlorhexidine digluconate mouthwash were prescribed during the postoperative period. There was no postsurgical complaints from the patient.

Results: CO2 laser worked well while making the excision with its hemostatic effect. No recurrence was seen in the two years follow-up period.

Conclusion: CO2 laser therapy can be used as a primary alternative method in the treatment of lymphangiomas. It can be safely used and recurrence may be less than conventional excision with scalpel. However, long-term clinical follow-up is neccessary for the recurrence of the lesion.

Clinical significance: CO2 laser treatment can be used safely in the treatment of lymphangiomas.