The use of laser for leukoplakia ablation

Introduction: The term oral leukoplakia is a clinical diagnosis for a predominantly white lesion which is not immediately recognizable as another well definable lesion which is white in appearance. A patient with oral leukoplakia is generally referred to take a biopsy for a definitive histopathological diagnosis. The outcome of the histopathological study, which may vary from hyperkeratosis to invasive squamous cell carcinoma, will determine the treatment. Because of the risk of malignant transformation, many clinicians recommend the ablation of the lesion. Long term follow-up is indicated. Objective: The aim of this poster is to demonstrate one leukoplakia case with a relevant dimension on the tongue. Description of the case: A 62-year-old female patient was diagnosed with a white plaque lesion on the left side of the tongue. An incisional biopsy was previously performed and the histopathologic analysis indicated the presence of mucosa with keratosis without dysplasia. The diagnosis was leukoplakia with no dysplasia. The patient was referred for completed excision. The lesion was removed with safety margins using a LASER Diode (DenLaseⓇ) with power 4W, fiber 400 µm and pulse mode of 50-200 µs. The piece was sent for analysis and the first diagnosis was confirmed. Follow-up at 2 weeks and 3 months. Discussion: The malignant transformation of oral leukoplakia is about 3.5%, being the tongue one of the localizations with a higher risk. Consequently the complete ablation of the lesion is indicated. LASER has numerous advantages such as a better view of the surgery field, reduction of anesthetic needed, hemorrhagic risk and post-operatory symptomatology, when compared with conventional surgery. LASER Diode promotes coagulation during the surgery which helps the healing process. In extensive lesions, no need of suture could be an advantage. Due to the impossibility of closing the margins, a change of the original anatomy is prevented. The chance of removing with no vaporization increases the possibility of a new analysis. Conclusions: After the definitive differential diagnosis of a leukoplakia lesion, LASER is a safe and suitable option to removed oral lesions in particular cases, as an alternative of conventional surgery methods. The patient's comfort in the post-operatory time is probably the most important benefit from laser technique. Long-term follow-ups are always indicated because of the potentially malignant transformation. Keywords: Laser, oral surgery, biopsy, ablation, leukoplakia