Lymphatic Malformation (LM) according to ISSVA Classification, is a rare benign disorder with unknown
aetiology. LM may grow slowly over years or develop rapidly over the course of days becoming a bulky lump, infected
or bleeding. We propose our three steps Diode Laser protocol for LM management, based on its persistent vascular blood
component.
1. Histological and cytological examination, to evaluate the vascular blood component (10-40%), shows mature
lymphocytes with red blood cells and endothelial cells.
2. Diode Laser Photocoagulation (DLP) in pulsed mode (on 100ms / off 400ms) at 10W and 800nm with a 300μm
fibre kept 2-3mm from the tissues, to reduce the lesion.
3. Diode Laser surgical excision in pulsed mode (on 50ms / off 200ms) at 8W and 800nm with a 300 μm fibre in
close contact with tissues, and histological intraoperative margins control on frozen sections.
Even if it has inconstant results (lesions decreasing rate is 10% to 40% proportionally to vascular blood component),
DLP simplifies the last and the most important step. Use of Diode Laser also in surgical excision reduces intra and postoperatory complications.
Hereditary Haemorrhagic Telangiectasia (HHT) is a muco-cutaneous inherited disease. Symptoms are epistaxis,
visceral arterio-venous malformations, multiple muco-cutaneous telangiectasia with the risk of number increasing
enlargement, bleeding, and super-infection. The aim of this work is to show the dual Diode Laser efficacy in preventive
treatment of Early Lesions (EL < 2mm) and therapeutic treatment of Advanced Lesions (AL < 2mm). 21 patients
affected by HHT with 822 muco-cutaneous telangiectatic nodules have been treated in several sessions with local
anaesthesia and cooling of treated sites. EL preventive treatment consists of single Laser impulse (fibre 320) in ultrapulsed
mode (2 mm single point spot). AL therapeutic treatment consists of repeated Laser impulses in pulsed mode (on
200ms / off 400ms). According to the results, Diode Laser used in pulsed and ultra-pulsed mode is very effective as noninvasive treatment both in early and advanced oral and perioral telangiectasia.
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