The use of CO_2 laser in salivary gland diseases

摘要

Salivary gland diseases can include reactive lesions, obstructive lesions, and benign tumors. All these clinical entities are slow growing. Salivary glands reactive lesions, such as mucoceles, can result from extravasation of saliva into the surrounding soft tissue or from retention of saliva within the duct. Sialolithiasis, one of the most common obstructive lesions, is generally due to calculi, which are attributed to retention of saliva. Monomorphic adenoma is a salivary gland benign tumor, which is exclusively resulted from proliferation of epithelial cells, with no alterations interesting the connective tissue. The elective therapy of these lesions is surgical excision because sometimes they can be accompained by difficulties during chewing and phonation and can interfere with prosthesis's stability. The aim of the study is to evaluate the efficacy of CO_2 laser in the treatment of patients with salivary gland diseases. Three different cases - a mucocele, a scialolithiasis and a monomorphic adenoma - were treated with CO_2 laser excision (CW and 4W), under local anesthesia. Two different techniques were used: circumferential incision for the adenoma, and mucosa preservation technique for mucocele and sialolithiasis. In each case final haemostasis was obtained by thermocoagulation, but suture was applied to guarantee good healing by sewing up the flaps. The patients were checked after twenty days and the healing was good. The carbon dioxide laser (CO_2 laser) was one of the earliest gas laser to be developed, and is still the highest-power continuous wave laser that is currently available. In dentistry the CO_2 laser produces a beam of infrared light with the principal wavelength bands centering around 9.4 and 10.6 micrometers. Laser excision can be very useful in oral surgery. In the cases presented CO_2 laser offered, differently from traditional surgery, simplified surgical technique, shorter duration of operation, minimal postoperative pain, minimal scarring, bloodless field and the possibility to realize minimally invasive surgery. These advantages made the operation tolerable for the patients, that became more compliant. Optimum functional results can be expected.