The use of laser and Varioscope in the management of hemangiomas and vascular malformations

Vascular lesions are common in infants and children and can be grouped into two main classifications: vascular tumors and vascular malformations. Hemangiomas are proliferative lesions characterized by increased endothelial cell turnover. Vascular malformations are congenital abnormalities involving capillaries, veins and/or lymphatics. A multidisciplinary approach regarding diagnosis and treatment of vascular anomalies in children is crucial. Several options are available for the treatment of hemangiomas. Since January 2003, 14 cases of hemangioma located in the cervicofacial region were treated at "La Sapienza" University. Seven patients underwent surgical resection, using Varioscope, and seven laser therapy. The Varioscope is an operating microscope, which is mounted on the head. Specific advantages convinced the authors to use the Varioscope initially. Autofocus, a magnification range between 3.6-7.2X and automatic parallax control allow unlimited freedom of movement which alleviates the discomfort of keeping the same distance for a long time. Laser therapy can selectively destroy specific targets within the skin by using an appropriate wavelength and pulse duration. Laser treatment parameters are based on several factors, including lesion location, lesion morphology, and patient skin type. The purpose of our study was aesthetic and functional improvement in patients comparing surgical and laser therapy. We obtained an aesthetic improvement in 11 patients and local pain control in all patients. Analysis of the cosmetic results was subjective but all parents indicated satisfaction with their decision regarding their child's treatment.