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Efficacy and Safety of Lasers in Treating Head and Neck Capillary Malformations: A Systematic Review and
Soroush Farsi1, Peter Eckard1, Walker Bartels1
1Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Objective:
This study aims to comprehensively review and compare the safety and efficacy of commonly used lasers in the management of head and neck capillary malformations (CMs).
Data Sources:
PubMed, Embase, Cochrane, and Web of Science.
Review Methods:
Databases were searched from inception to August 2023. Study protocols adhered to the PRISMA guidelines. Cohort studies reporting CM laser treatment outcomes were included. Study validity was tested using the Newcastle-Ottawa Scale. Meta-analysis was conducted using the inverse variance method and a fixed effects model, with treatment success defined as achieving 25% to 100% clearance of the lesion.
Results:
A total of 725 studies were screened, and 14 full-text articles met the criteria, comprising 714 patients. Patients underwent a mean of 6.5 laser treatment sessions, consisting of 80% pulsed dye laser (PDL), 12% neodymium-doped yttrium-aluminum-garnet laser (Nd:YAG), and 8% 577 nm yellow laser treatments. Meta-analysis revealed an overall treatment success rate of 97% (95% confidence interval [CI]: 0.96-0.98). Subgroup analysis by laser type resulted a success rate of 96% (95% CI: 0.94-0.973) for PDL, 99% (95% CI: 0.979-1.008) for Nd:YAG laser, and 86% (95% CI: 0.7621-0.964) for 577 nm yellow laser. The complication rate by laser type was 9% (95% CI: 0.031-0.147) for PDL, 4% (95% CI: 0.007-0.080) for Nd:YAG laser, and no reported complication data for 577 nm yellow laser.
Conclusion:
The vast majority of the available data on laser treatment of head and neck CMs suggest excellent outcomes and low complication rate using PDL treatment. Centers using Nd:YAG laser reported a slightly higher rate of successful treatment with fewer complications than PDL or 577 nm yellow laser treatment.
