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Forums › Laser Treatment Tips and Techniques › Soft Tissue Procedures › Papilloma removal

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  • September 3, 2004 at 8:34 pm #3310 Reply

    dkimmel
    Spectator

    This is a 15mm dia. paplloma apearing lesion. The pat .says that it has been there  15 years. She had it removed and it returned. It gets large then breaks off and returns.
    I used the chisel tip at 1.25 W with  20% air and 10 % water.
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    Afraid to say that this will occur again as I don’t believe I got enough of the base of the lesion removed.

    DavidDSC_0008w1.jpg

    September 3, 2004 at 8:51 pm #10096 Reply

    Glenn van As
    Spectator

    Is she a smoker, I guess that you sent it in for biopsy.

    Interesting technique using the chisel tip. I might have been inclined to use a soft tissue tip to remove the bulk of the lesion and then go at it with the chisel tip flat on to try and reduce the deeper portions. I might have gone right down to the osseous and let it granulate in.

    What could we cover it up with afterwards that would help reduce the discomfort of bone exposed to air.

    Just thinking out loud here.

    David , neat case and cool photos……if whe wasnt a smoker , I wonder how it got there!!

    Better have your wife in the room for the follow up photos……..

    Grin

    Glenn

    September 8, 2004 at 5:35 pm #10095 Reply

    Samuel Moss
    Spectator

    David,

    I need to check out these not so new tips…I guess I see a Barr/Colona course on the horizon.

    I remember a lesion like this from a lady when I was in Dental School. The patient WAS a smoker. Also edentulous and the lesions were on the little ridge she had left. However, hers was on the anterior maxilla. The path lab came back with a report of verrucous carcinoma. Please keep us posted with what the lab report is.

    Mossman

    September 9, 2004 at 8:07 pm #10094 Reply

    Samuel Moss
    Spectator

    David or Glenn,

    BTW, Do those curved Delight tips fit on the Waterlase handpiece? They seem to be “out of the way” when doing CL, etc. Just wondering

    Sam

    September 9, 2004 at 11:47 pm #10098 Reply

    Glenn van As
    Spectator

    I dont think they do fit and in addition I am sure it would void your warranty.

    Maybe someone like Allen or David who has access to both lasers can tell you.

    Glenn

    September 10, 2004 at 3:38 am #10101 Reply

    Swpmn
    Spectator
    QUOTE
    BTW, Do those curved Delight tips fit on the Waterlase handpiece?  They seem to be “out of the way” when doing CL, etc.  Just wondering

    Sam

    No, but if they did they would work way cool on the new Waterlase straight handpiece:cool:

    Al

    September 22, 2004 at 1:16 am #10092 Reply

    dkimmel
    Spectator

    Biopsy came back Papalloma. Have not seen her yet for a post op picture.

    September 22, 2004 at 3:40 am #10097 Reply

    Glenn van As
    Spectator

    A papilloma is viral , but was it anything that is serious. Do you think it will grow back?

    Inquiring minds want to know how it got there…..could you ask her.

    Grin

    Glenn

    September 22, 2004 at 11:15 am #10093 Reply

    dkimmel
    Spectator

    Sure I think it will come back!
    Your a sick puppy. This is an 82 Y/O Great Grandmother.
    smile.gif
    DAvid

    September 22, 2004 at 1:17 pm #10099 Reply

    Glenn van As
    Spectator

    I wonder if it is from smoking or not. Secondly, I was wondering if the laser makes it worse and if we have to wear laser masks for the plume.

    Its a strong concern in my mind. I was only teasing you.

    Glenn

    September 22, 2004 at 9:14 pm #10090 Reply

    dkimmel
    Spectator

    Glenn, Finally you’ve taken the bait!
    The risk with reoccurance is high with a Papalloma. The patient and I discussed this and reviewed not waiting so long to have it removed.
    You are so right about the plume. High Volume suction was going at all times plus you do have to take other precautions. It is viral and can be spreaded to myself or staff. SO:
    DSCN1571w.jpg

    David

    September 22, 2004 at 10:35 pm #10102 Reply

    Swpmn
    Spectator

    Dave:

    Couple of questions on your case:

    Does the nitrous oxide help with concentration? Also, does attaching the gown top to the optical fiber suspension system aid in preventing “hat head”?

    A Tip for Other Rural Practitioners:

    When you are done with your “disposable” herpes/papilloma plume gowns like Dave’s, don’t throw them out. In Pasco County, Florida they double for stinger protection while you go out back to collect honey.

    Al

    September 22, 2004 at 11:20 pm #10089 Reply

    Anonymous
    Guest

    Wow, that atmospheric pressure must have gotten pretty low during the hurricaines. Didn’t it return to normal? :cheesy:

    September 23, 2004 at 12:35 am #10100 Reply

    Glenn van As
    Spectator

    David………how does that getup work with a scope………

    Are you loupes foggy……..

    Is your mind foggy.

    Do you wear those loupes to the mens room……..

    What an absolutely hilarious photo……PERFECT.

    You got me.

    Glenn

    September 23, 2004 at 12:43 am #10091 Reply

    dkimmel
    Spectator

    Nothing is better then having a little fun at the end of the day!!!

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