Published: 2022-08-25

Surgical excision of lobular capillary hemangioma with laser under N2O/O2 conscious inhalational sedation in an uncooperative pediatric patient, Frankl class 2: a case report

Dempsy Chengappa M. M., Saugat Ray, Andrews Navin Kumar, Rahul Kaul, Sandeep Mehta, Benjith Paul


Here, we report a case of lobular capillary hemangioma (LCH) associated deleterious oral habit on lateral border of the tongue in an anxious child excised under nitrous oxide (N2O) sedation using soft tissue diode laser. LCH are rapidly growing vascular lesions and are common occurrence over tongue, but to be associated with deleterious oral habit is an uncommon occurrence. A 9-year-old female child was brought to the dept by her parent due growth on the tongue. The child was quite anxious and displayed negativity towards examination and treatment. The child was classified as Frankl 2 on the behaviour rating scale. A pre-anaesthetic check-up was carried out on the child as it was envisaged to carry out the treatment under inhalational sedation. The anaesthesiologist along with crash cart were present throughout the procedure to cater to any adverse events. The excision was done with 980-nm soft tissue diode LASER to reduce intraoperative haemorrhage, enhance patient comfort and improve postoperative healing. A novel combination of inhalational sedation with soft tissue diode LASER with all necessary precautionary protocols as used in management of this child may be an useful approach for successful and uneventful management. To highlight the importance of proper use of pharmacologic methods in behaviour management as well as surgical techniques for better management of these vascular lesions in children.



Pyogenic granuloma, LCH type, N2O, Inhalational sedation

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