title: Combining the CO2 laser and the endoscope to remove soft tissue masses from the forehead area.
abstract: OBJECTIVE
  The aim of this study was to provide a retrospective analysis of treatment that combines the laser and the endoscope.
  
  
  BACKGROUND
  Previously, surgeons faced many complications arising from endoscope-assisted surgery in the region of the forehead. In order to reduce the incidence of complications, such as swelling and hematoma, the CO2 laser is added to endoscope-assisted surgery.
  
  
  METHODS
  Between January 1996 and January 2003, 42 patients were treated for the removal of a benign tumor. The group was comprised of 18 males and 24 females, and their ages ranged from 5 to 64 years. The SurgiLase 150XJ CO2 laser system, used in conjunction with the flexible FIBERLASE (Sharplan, NJ), was used in all cases. The endoscope was 4 mm in diameter, with an angle of 30 degrees (Snoden Pancer, USA). The dissection was performed by relaying images from the endoscope to a monitor. The basic instrumentation consists of elevators, a nerve hook, retractors, and endoscopic scissors. Suction of the smoke generated by laser evaporization was also necessary.
  
  
  RESULTS
  Of the 42 cases treated, 30 patients displayed lipomas, 10 patients displayed inclusion cysts, and two patients displayed dermoid cysts. After surgery, the follow-up period ranged from 6 months, to 2 years and 6 months, with an average of 1 year and 7 months. In this retrospective review, the incidences of early complications of these 42 patients included one case of scalp alopecia, three of scar alopecia, one of numbness, and three of ecchymosis. No hematoma cases were recorded. Evaluation after 6 months revealed the later complication of one scar alopecia.
  
  
  CONCLUSIONS
  SurgiLase CO2 laser, used in conjunction with endoscopic surgery, enables plastic surgeons to work at a distance through small incisions without causing bleeding. Visible scars are reduced and recovery time is diminished.
authors.affiliation: Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan. chengjen@adm.cgmh.org.tw
authors.forename: Cheng-Jen
authors.initials: CJ
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D002245:Carbon Dioxide; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000517:prevention & control; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003884:Dermoid Cyst / Q000175:diagnosis / Q000601:surgery; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D004954:Esthetics; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008067:Lipoma / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D002245:Carbon Dioxide