Image-Guided Excision of Oral Leukoplakia Using Narrow-Band Imaging Illumination and Two-Stage Local Anesthesia

Area of Science:

• Oral Medicine
• Surgical Oncology
• Medical Imaging

Background:

• Oral leukoplakia requires complete excision to prevent malignant transformation.
• Standard local anesthesia can obscure lesion margins due to blanching.
• Accurate margin delineation is crucial for successful oral leukoplakia treatment.

Purpose of the Study:

• To evaluate narrow-band imaging (NBI) for guided excision of oral leukoplakia.
• To assess a two-stage local anesthesia protocol to overcome anesthetic-induced blanching.
• To determine the efficacy of NBI-guided excision in achieving complete lesion removal.

Main Methods:

• A two-stage local anesthesia protocol was employed: plain lidocaine followed by lidocaine with epinephrine.
• Excision margins were defined using narrow-band imaging (NBI) illumination with a carbon dioxide laser.
• Twenty-one patients with 50 oral leukoplakia lesions underwent NBI-guided excision.

Main Results:

• All surgical margins were confirmed to be free of residual oral leukoplakia disease.
• A low recurrence rate of one lesion was observed during follow-up.
• No malignant transformations were noted in any of the treated patients.

Conclusions:

• NBI-guided excision combined with two-stage local anesthesia effectively enhances visualization of oral leukoplakia.
• This technique facilitates precise margin delineation, leading to complete lesion removal.
• The approach shows promise for improving treatment outcomes and reducing recurrence in oral leukoplakia management.