Intralesional photocoagulation of vascular anomalies of the tongue

Vascular anomalies remain a challenge for patients and reconstructive surgeons. Recently, promising results have been reported using intralesional photocoagulation (ILP) to treat large, deep vascular lesions. We report our experience in treating 12 patients with vascular anomalies of the tongue (10 venous malformations and two haemangiomas) using intralesional photocoagulation. All patients were treated with a Nd:YAG (neodymium:yttrium-aluminium-garnet) (1064 nm) laser (Sharplan, Inc., NJ, USA) delivered with a 600 μm optical fibre. Laser power was set at 7 or 10 W, delivered with a pulse duration of 10 s. Laser energy was delivered to all areas of the vascular lesion. Heat, visible shrinkage and firmness of the lesion signalled the end-point of treatment. The mean follow-up period was 9.5 months (range 3-20 months). All patients demonstrated improvement as judged by a clinical assessment of the reduction in lesion size (mean reduction = 87%, range 60-100%). Three patients (25%) had complications attributed to photocoagulation. Energy delivered too superficially resulted in ulceration or scarring. These complications should be avoidable if this potential for harm is kept in mind.