Hemangioma surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]
Overview
Surgery is not the first-line treatment option for patients with hemangioma. It is usually reserved for patients with either massive protuberant proliferating hemangioma and lesions that are refractory to less invasive treatments.
Surgery
- Surgical management involves excision, laser treatment or both. [1][2]
- Intralesional steroid treatment is also an option for focal hemangiomas such as:
- Parotid
- Nasal tip
- Subglottis
- Eyelid
- Repeat therapy is often required, but systemic side effects are limited.
- Excision is the appropriate for localized lesions the fibrofatty remnants (residuum) of involuted hemangiomas.
- Elective subtotal excision of massive protuberant proliferating hemangiomas can be employed in order to maintain aesthetic facial boundaries.
- Small remnants of disease are then left for involution.
Excision
- Excision is the appropriate for localized lesions the fibrofatty remnants (residuum) of involuted hemangiomas.
- Elective subtotal excision of massive protuberant proliferating hemangiomas can be employed in order to maintain aesthetic facial boundaries.
- Small remnants of disease are then left for involution.
Phototherapy
Pulsed dye laser
Pulsed dye laser is considered to be effective choice for a series of skin disorders including superficial hemangiomas.[3]
- Residual erythema and telangiectasias frequently remain in involuted hemangiomas and are best treated by selective photothermolysis using the flash pulse dye laser (FPDL).
- Ulcerative lesions during proliferation can be treated with FPDL to induce healing and new epidermal growth.
Intense pulsed light
- IPL flash lamps emit broadband polychromatic high-intensity light in the wavelength spectrum ranging 515-1200nm.[3]
- They target vessels at various depths inside the skin.
- The effect relies on selective photothermolysis.
- The indication spectrum includes vascular tumors including hemangiomas.
References
- ↑ Callahan, Alison B.; Yoon, Michael K. (2012). "Infantile hemangiomas: A review". Saudi Journal of Ophthalmology. 26 (3): 283–291. doi:10.1016/j.sjopt.2012.05.004. ISSN 1319-4534.
- ↑ Richter, Gresham T.; Friedman, Adva B. (2012). "Hemangiomas and Vascular Malformations: Current Theory and Management". International Journal of Pediatrics. 2012: 1–10. doi:10.1155/2012/645678. ISSN 1687-9740.
- ↑ 3.0 3.1 Caucanas, Marie; Paquet, Philippe; Henry, Frédérique; Piérard-Franchimont, Claudine; Reginster, Marie-Annick; Piérard, Gérald E. (2011). "Intense Pulsed-Light Therapy for Proliferative Haemangiomas of Infancy". Case Reports in Dermatological Medicine. 2011: 1–5. doi:10.1155/2011/253607. ISSN 2090-6463.