Luomanen M
Department of Anatomy, University of Helsinki, Finland.
Proc Finn Dent Soc. 1992;88(1-2):49-55.
Fifty-six patients with 86 benign oral soft-tissue lesions were treated with CO2 laser surgery during a period of 48 months. The lesions removed included hyperplasias, papillomas, haemangiomas, mucoceles, lichen planus, fibromas, condylomas and lingual frenula. All clinical diagnoses except that of lingual frenulum were verified histopathologically. The lesions were excised using the laser to obtain biopsy specimens. However, in some cases it was felt more appropriate to excise biopsy material from the most characteristic part of the lesion first, then to destroy the rest of the lesion. Treatment was undertaken in one session under local anaesthesia without premedication. No patient received antibiotics or anti-inflammatory drugs after operation. The lesions were operated on freehand using a handpiece and laser power ranging from 6 to 10 W in continuous mode. The beam in focus was 0.2 mm in diameter, which allowed fine dissection. There was no bleeding from the laser wounds, and no need for suturing. Removal of the lesions using the laser was fast and easy. Healing took place with minimal post-operative discomfort, and without visible scarring. The results of this study suggest that use of a CO2 laser leads to a level of precision similar to and sometimes better than that of a scalpel in the treatment of benign oral soft-tissue lesions. The laser beam could be used to obtain biopsy specimens without tissue destruction.
在48个月的时间里,对56例患有86处口腔良性软组织病变的患者进行了二氧化碳激光手术治疗。切除的病变包括增生、乳头状瘤、血管瘤、黏液囊肿、扁平苔藓、纤维瘤、尖锐湿疣和舌系带。除舌系带外,所有临床诊断均经组织病理学证实。使用激光切除病变以获取活检标本。然而,在某些情况下,先从病变最具特征性的部位切除活检材料,然后破坏病变的其余部分被认为更为合适。治疗在局部麻醉下进行,无需术前用药,且未进行单次治疗。术后无患者接受抗生素或抗炎药物治疗。使用手持器械和连续模式下功率为6至10瓦的激光对病变进行徒手操作。聚焦光束直径为0.2毫米,便于精细解剖。激光伤口无出血,无需缝合。使用激光切除病变快速简便。愈合过程中术后不适最小,且无明显瘢痕形成。本研究结果表明,在治疗口腔良性软组织病变时,使用二氧化碳激光可达到与手术刀相似甚至有时更好的精确程度。激光束可用于获取活检标本而不破坏组织。