Laser treatment of complicated head and neck hemangiomas in infancy.

A retrospective study of 73 patients treated for symptomatic hemangiomas of head and neck from May 1981 to April 1994 was conducted. Fifty-three females and 20 males ranging in age from 1 day of life to 11 years with the average age being 19 months were reviewed in the University of California, Irvine Medical Center. All patients were referred by pediatricians or family practitioners for evaluation and possible laser treatment. The lesions reported were particular troublesome because of obstruction of orifice(s), repeated ulceration, bleeding, subsequent pain or life threatening. Various lasers have been used for these patients including: CO2 laser [10], Argon laser/with intralesional steroid injection [33/14], Nd YAG laser [21], KTP laser [1] and Flashlamp-pumped pulsed dye laser (FPPDL)[8]. All treated lesions healed in 7 to 21 days (mean, 12 days). Complications associated with laser treatment, such as postoperative bleeding and infection were not seen. The symptoms were totally relieved from 7 days to 24 months (mean, 9 months). Combined with reconstructive surgery, the texture changes (7 patients) after laser treatment were corrected successfully. The outcome was graded by reduction in volume, improvement of color and texture of hemangioma as follow: Grade 1 - Poor (0-25%); Grade II - Fair (26-50%); Grade III - Good (51-75%); Grade IV - Excellent (76-100%). The final results of the patients are similar to what may be expected after spontaneous involution of a complicated hemangioma. In summary, complicated hemangiomas of head and neck in infancy have significant morbidity that can be efficiently avoided with the use of laser therapy.