Laser Treatment for Leukoplakia
Leukoplakia is a cancerous condition. This condition can be treated with various treatment plans which follow a procedure. If the conditions is not treated, then conservative, surgical and laser treatment methods are used. In this article, there is a brief discussion on the laser treatment for leukoplakia. Read on to know more.
Laser treatment for leukoplakia
LASER stands for Light Amplification of Stimulated Emission of Radiation. The most commonly used lasers for oral lesions are COâ‚‚ lasers due to their greater affinity for any of the tissues with a high water content and with their minimum depth for penetration, i.e., 0.2 – 0.3 mm in the oral tissue. These CO lasers contain nitrogen, helium gases and CO.
In performing excisional or incisional biopsy in cases for treating leukoplakia, COâ‚‚ laser is useful as a precise cutting tool. During the process, laser is placed in a focused or cutting mode and held perpendicular to the affected tissue. A surgical predetermined outline is followed by the means of the tissue pickup, then the outline border is raised and then the lesion is undermined with counter traction and traction as it would be done with the help of a scalpel.
Laser peel is used usually for the removal of lesion which involves a relatively larger surface area.
- Beam is generally highly defocused and is kept a distant away from the tissue. No effect would be seen initially over the tissue plane.
- Gradually, beam is brought closer into the focus, but it is still in the defocused mode until the tissue shows white appearance and begins to develop blister.
- At the base of the tissue membrane, blistering occurs.
- This technique of whitening is extended all over the lesion (the rest part which needs to be peeled).
- Grafting is done over this white area with hemostat or tissue forceps and then it is laser peeled away for exposing the underlying tissue area or vitalization.
Ablation is a painting method, where the tissue or lesion which is removed by laser technique is painted.
- In this method, the tissue is vaporized simply and is a noncontact surgical application.
- It is applied particularly to larger sites of leukoplakia, when the surgical excision would create major problems of reconstruction and morbidity.
- Surface vaporization is done to a depth of 0.5 mm approximately and will normally result in a good secondary re-epithelization with the normal mucosa.
- During this surface ablation, carbonized layer must be removed before the deeper layer is ablated.
This therapy is used only in the neoplastic tissue. It has also been tried in other tissues, but late observation has been failed to show a complete success.
In limited cases of the leukoplakia condition, topical application of these anticancer chemotherapeutic agents such as human fibroblast interferon and bleomycin have been used with a good success rate.
Important guidelines for the leukoplakia treatment:
- Biopsy must be done.
- Leukoplakia condition which doesn’t heal within 2 -3 weeks after the elimination of the demonstrable etiological factors require surgical and conservative treatment.
- Conservative treatment is generally done to a larger incipient lesion with large verrucous lesions and keratinization, to reduce the lesion size before the surgical intervention.
- If the conservative treatment fails in producing a complete healing even after 3 months at latest, then surgical treatment is used.
- Because of greater risk of verrucous and nodular leukoplakia to become malignant, these lesions excision is essential with adequate follow up.
- To prevent the malignant changes, all the leukoplakia patients are summoned for re-examination of the condition for at least two times in a year.
- Re-biopsy must be done after 5 -6 months.
- About 6 -10% of leukoplakia with dysplasia evidence may progress to malignancy.
- Recurrence of lesions will often follow up with excision.
The above article discusses about the laser treatment for leukoplakia. Individuals experiencing any signs of developing leukoplakia must go for a thorough diagnosis and consult their doctor for complete treatment guidance.