Recurrence of premalignant oral cavity and oropharynx lesions after pulsed diode laser treatment

Am J Otolaryngol. 2022 Sep-Oct;43(5):103556. doi: 10.1016/j.amjoto.2022.103556. Epub 2022 Aug 3.


Purpose: Leukoplakia is common with a 1 % incidence in the population and may harbor preneoplastic changes. Diode lasers provide both precision and coagulation for excision of superficial lesions in clinical and operative settings with little damage to deeper tissue. We aim to determine the rate of oral and oropharyngeal hyperkeratosis and dysplasia recurrence after treatment with diode laser.

Materials and methods: Patients with oral or oropharyngeal hyperkeratotic or mild dysplastic lesions treated with pulsed diode laser between 2013 and 2020 at a tertiary academic institution were analyzed. The main outcome measure was recurrence of hyperkeratosis and dysplasia after treatment.

Results: Fourteen patients received diode laser treatment for hyperkeratotic or mild dysplastic lesions of the oral cavity or oropharynx. Demographic features included 9 (64.3 %) females and mean age of 66.6 years. In these 14 patients, 18 distinct lesions were identified. Eleven (61.1 %) lesions were located on the oral tongue, 4 (22.2 %) on the buccal mucosa, 2 (11.1 %) on the hard palate, and 1 (5.6 %) on the soft palate. Average time from lesion clinical diagnosis to the first diode laser treatment was 8.3 months with an average number of 1.4 treatments per lesion. Three (16.7 %) lesions experienced recurrence after the most recent treatment. None of the lesions underwent malignant transformation. None of the patients experienced bleeding, tethering, or dysarthria after treatment. One patient developed pyogenic granuloma and reported chronic tongue pain.

Conclusions: Pulsed diode laser treatment of leukoplakia was well tolerated with low complication rates and reasonable control of precancerous lesions.

Keywords: Dysplasia; Leukoplakia; Oral cavity; Premalignant; Pulsed diode laser.

MeSH terms

  • Aged
  • Female
  • Humans
  • Lasers, Semiconductor / therapeutic use
  • Leukoplakia, Oral / epidemiology
  • Leukoplakia, Oral / pathology
  • Leukoplakia, Oral / surgery
  • Male
  • Oropharynx / pathology
  • Pharyngeal Diseases*
  • Precancerous Conditions* / pathology
  • Precancerous Conditions* / surgery
  • Tongue / pathology