Photomedicine and Laser Surgery Volume 26, Number 2, 2008 © Mary Ann Liebert, Inc. Pp. 113–118 DOI: 10.1089/pho.2007.2143 Treatment of Hemangioma of the Head and Neck with Diode Laser and Forced Dehydration with Induced Photocoagulation FRANCESCA ANGIERO, M.D., 1 STEFANO BENEDICENTI, D.D.S., 2 GEORGIOS E. ROMANOS, D.D.S., 3,4 and ROLANDO CRIPPA, M.D. 5 ABSTRACT Objective: The aim of this study was to investigate the efficacy of treating oral hemangiomas using forced de- hydration with induced photocoagulation (FDIP) via diode laser. Methods: One-hundred sixty patients were treated between 1999 and 2006 (76 men, 46%; 84 women, 54%). In 136 cases we used FDIP to treat heman- gioma, and in 24 cases complete surgical excision was performed. One-hundred thirty-four lesions had a sur- face area 2  2 cm 2 , whereas only two had large lesions measuring 2.5  2 cm 2 . Results: In 136 patients with hemangiomas treated with FDIP, 134 cases (98.53%) showed complete remission, one case (0.735%) did not show complete remission, and one case (0.735%) displayed tumor growth. There were no adverse effects and all patients were carefully followed-up until complete healing was documented, along with any compli- cations. Conclusions: Our findings suggest that FDIP is a useful and effective treatment for benign oral vas- cular lesions. FDIP treatment of these oral lesions is clinically significant because it provides effective man- agement, avoids recurrence, and shortens healing time. We believe that the use of this method by medical and dental specialists should be supported. 113 INTRODUCTION B ENIGN VASCULAR LESIONS are relatively common in the head and neck, 1–3 but their classification and nomenclature are divergent. In 1996, the International Society for the Study of Vascular Anomalies approved a classification system modified from Mulliken and Glowacki. 4 Vascular diseases were subdi- vided into (1) tumors, which includes hemangioma, pyogenic granuloma, rapidly involuting congenital hemangioma, nonin- voluting congenital hemangioma, hemangiopericytoma, tufted angioma, and kaposiform hemangioendothelioma; and (2) vas- cular malformations. 5 Clinically, the hemangioma is a red macula, mass, or swelling that develops during late fetal stages or in infancy, grows quickly, and generally undergoes spontaneous regres- sion. Hemangioma has three different phases: proliferating, in- volution, and involuted. The proliferating phase (0–1 year of age) corresponds to increased activity and proliferation of en- dothelial cells with organization of masses, in some cases show- ing vascular lumens. The involution phase (1–7 years of age) is characterized by an initial maturation of blood vessels with dilatation of the vascular lumen and decreased cellular activity. The involuted phase is a final maturation of the lesion with a few tiny capillary-like feeding vessels and draining veins lined with flat mature endothelium. 5,6 There are various treatments for hemangiomas. Surgery has been the main form of treatment for these lesions, although sometimes total removal is not possible because of the extent of the lesion, which may involve vital structures. Other possi- bilities include embolization, steroid therapy, cryosurgery, elec- trodesiccation, and laser therapy, which was introduced in 1960. 7–14 With the introduction of laser therapy, a new alter- native emerged. The 810–830 nm diode laser beam is poorly absorbed by water and selectively absorbed by hemoglobin. Due to its poor absorption by water, the laser penetrates deeply into the tissue, down to a depth of 4–5 mm. As it passes through the tissues, the laser beam generates heat and thus coagulates tissue down to a depth of about 7–10 mm, a process called pho- 1 Anatomia Patologica, Ospedale San Gerardo, Monza (Mi), Italy. 2 University of Genova, Department of Science and Technology, Genova, Italy. 3 Director of the Unit of Laser Dentistry at the Eastman Dental Center, Rochester, New York. 4 University of Frankfurt, Department of Oral Surgery and Implantology, Frankfurt, Germany. 5 Advanced Oral Laser Surgery Service, Italian Stomatologic Institute, Milan, Italy.