Forums › Diode Lasers › General Diode Forum › diode for hemangioma tx
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cadavisSpectatorI have a 980nm diode (Sirolase) and a patient with a hemangioma on his lower lip. It is approx 1cm X 1.5cm in size. I have seen two discussions on the tx of these lesions. One was out of contact tx. The other was incise, drain, re-enter to destroy walls. I am thinking of going with the invasive option using 320um fiber, 3W, 10hz, large volume suction.
It is my understanding that you incise, allow to drain, then re-enter at same setting, and make full circle laterally to destroy inner walls of hemangioma area. Is this correct. Also, would 20 seconds be sufficient (or excessive?)Any input would be appreciated.
Chris Davis
BenchwmerSpectatorOn ALD (Academy Laser Dentistry) site DR. Hatcher-Rice shows this exact case with diode.
Check her parameters. 20 seconds sounds like too much laser with diode.
Jeff
cadavisSpectatorThanks Jeff,
I’ll check it out.Chris Davis
BenchwmerSpectatorI had a minute, Winter 2004 Wavelength Journal
Paraphrasing case:
she used 830nM Diode
600 micron fiber
Continuous wave, 1.0 Watt
She started 10mm away defocused, moved towards lesion, entered lesion, circular motion inside venous lake, then defocused for hemostatis. Total time 1 minute.
With your parameters and 320 fiber, less than 10 seconds within lesion.
Jeff
cadavisSpectatorgood info,
thanksChris Davis
Kenneth LukSpectatorbe ware of heat building up.
Chance of scare formation/loss of lip pigmentation with excessive power ?
You can always touch up if the area is not completely healed after a few months.
Ken(Edited by Kenneth Luk at 1:41 pm on Sep. 5, 2006)
cadavisSpectatorThanks Ken.
Good tip
HubertSpectatorGeorge Romanos from Frankfurt, now New York, has discribed a case of hemangioma removal with a diode laser under an ice-cube. The ice-cube is put on top of the lesion. It should be translucent for better transmission. Laser beam is aimed at lesion through the ice cube in non-contact to the tissue. Because of the cooling pain is seldom reported. The size of the hemagioma seems to shrink immediately, tissue turns greyish-white under tx.
The rationale to this tx is as follows: Shrinkage of tissue occurs through cooling which in return leads to higher concentration of -pigmented-red bloodcells which leads to higher absorption of laser energy.
I have not had the chance to do one myself but the rationale seems convincing and George R. is a very bright guy. Sorry, I have not found parameters used other than 8 Watts. The case is presented in his book “Atlas der chirurgischen Laserzahnheilkunde”, Urban and Fischer.Hope this helps
Best
H.
cadavisSpectator8 Watts, WOW! Mine doesn’t even go to 8W. Sounds interesting though. I completed my case yesterday and it seemed to turn out about like what was described in the article Dr Hatcher-Rice preseted in the Wavelength Journal. I’ll be following up on it in a week and a half.
Chris Davis
(Edited by cadavis at 5:58 pm on Sep. 6, 2006)
HubertSpectatorGlad to hear it worked. I would probably be too concerned about hemorhage when incising and “draining” as venous pools could drain for an awful long time.
Thanks for sharing!
Hubert -
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