Efficacy of Nd: YAG laser photocoagulation versus sclerotherapy in the treatment of oral vascular malformations (A Randomized controlled clinical trial)

Background: Treatment of vascular malformations (VMs) is a challenging endeavor for oral and maxillofacial surgeons regarding maintaining aesthetic integrity and functionality. Bleomycin sclerotherapy has been described as effective, & Nd:YAG laser appears to be one of the promising therapeutic options.Aim: To assess the efficacy of Nd:YAG laser photocoagulation versus bleomycin sclerotherapy in the treatment of oral venous VMs. Materials and methods: Twenty-two patients with oral low-flow venous VMs participated in a randomized clinical trial. Patients were randomly allocated into Nd:YAG laser & bleomycin sclerotherapy groups. The patients were assessed for the clinical healing response & post-operative complications. Statistical analysis was performed, and significance was set at the 5% level.Results: The Nd-YAG laser group showed early significant improvement in the clinical healing response over the bleomycin group. Pain was significantly higher in the bleomycin groups on the first postoperative day but decreased later. No significant differences were found in postoperative complications except for the bleeding incidence, where it was significantly higher in the bleomycin group.Conclusion: Nd-YAG laser photocoagulation and bleomycin sclerotherapy efficiently treat oral venous VMs with minimum postoperative complications and no recurrence. Nd-YAG laser demonstrates significantly faster clinical healing responses, as well as causes significantly less pain, no bleeding, and has better acceptance by the patients. while bleomycin sclerotherapy is better in the case of esthetically visible venous VMs when the risk of scarring is present.