[Papilloma excision. Scalpel or CO2 Laser? A case report]

Area of Science:

• Oral Pathology
• Surgical Oncology
• Dermatology

Background:

• Papillomas are benign epithelial tumors, often linked to human papillomavirus (HPV).
• Intraoral papillomas typically present as asymptomatic lesions, frequently on the tongue.
• Verrucous papules are a specific morphology of papilloma requiring surgical intervention.

Purpose of the Study:

• To compare the efficacy and outcomes of two surgical techniques for removing bilateral tongue papillomas.
• To evaluate scalpel excision versus CO2 laser ablation in terms of application, wound healing, biopsy quality, and patient morbidity.
• To provide insights into the management of intraoral papillomas using established and alternative surgical modalities.

Main Methods:

• A case report involving a 65-year-old male patient with bilateral verrucous papules on the posterior tongue.
• Surgical excision of the right-sided lesion using a scalpel (gold standard).
• Surgical removal of the left-sided lesion using a CO2 laser with a photothermal ablation technique.

Main Results:

• Scalpel excision demonstrated slightly faster wound healing and reduced postoperative discomfort compared to CO2 laser removal.
• Both surgical methods yielded comparable histopathological examination results.
• Morbidity was assessed, with scalpel removal showing a slight advantage in patient experience.

Conclusions:

• Scalpel excision remains a highly effective and preferred method for treating tongue papillomas, offering favorable healing and patient comfort.
• CO2 laser ablation is a viable alternative, though it may present with slightly slower healing and increased discomfort.
• Further comparative studies with larger patient cohorts are warranted to definitively establish the superiority of one method over the other for intraoral papillomas.