Combining the CO₂ laser and the endoscope to remove soft tissue masses from the forehead area

Objective: The aim of this study was to provide a retrospective analysis of treatment that combines the laser and the endoscope. Background Data: Previously, surgeons faced many complications arising from endoscope-assisted surgery in the region of the forehead. In order to reduce the incidence of complications, such as swelling and hematoma, the CO₂ laser is added to endoscope-assisted surgery. Methods: Between January 1996 and January 2003, 42 patients were treated for the removal of a benign tumor. The group was comprised of 18 males and 24 females, and their ages ranged from 5 to 64 years. The SurgiLase 150XJ CO₂ laser system, used in conjunction with the flexible FIBERLASE (Sharplan, NJ), was used in all cases. The endoscope was 4 mm in diameter, with an angle of 30° (Snoden Pancer, USA). The dissection was performed by relaying images from the endoscope to a monitor. The basic instrumentation consists of elevators, a nerve hook, retractors, and endoscopic scissors. Suction of the smoke generated by laser evaporization was also necessary. Results: Of the 42 cases treated, 30 patients displayed lipomas, 10 patients displayed inclusion cysts, and two patients displayed dermoid cysts. After surgery, the follow-up period ranged from 6 months, to 2 years and 6 months, with an average of 1 year and 7 months. In this retrospective review, the incidences of early complications of these 42 patients included one case of scalp alopecia, three of scar alopecia, one of numbness, and three of ecchymosis. No hematoma cases were recorded. Evaluation after 6 months revealed the later complication of one scar alopecia. Conclusions: SurgiLase CO ₂ laser, used in conjunction with endoscopic surgery, enables plastic surgeons to work at a distance through small incisions without causing bleeding. Visible scars are reduced and recovery time is diminished.