title: Assessment of pulsed-dye laser therapy for pediatric cutaneous vascular anomalies.
abstract: OBJECTIVE
  Although facial vascular malformations are often treated by facial plastic surgeons, no reliable validated assessment tool exists for surgeons to assess results.
  
  
  OBJECTIVE
  To use our assessment tool to analyze results from pulsed-dye laser therapy used for pediatric facial vascular malformations, and to determine interrater reliability of our assessment tool in a standard clinical environment without the use of professional photography.
  
  
  METHODS
  A blinded retrospective review of pediatric patients who underwent pulsed-dye laser therapy for treatment of hemangiomas of infancy (HOIs) and port-wine stains. Three pediatric otolaryngologists and facial plastic surgeons independently rated all of the pictures using our assessment tool.
  
  
  METHODS
  Tertiary care pediatric hospital.
  
  
  RESULTS
  Pulsed-dye laser therapy was performed in 22 patients, 17 with HOIs and 5 with port-wine stains. Patients with HOIs treated only by pulsed-dye laser showed, on average, a 50% to 75% improvement in color, 1% to 24%, improvement in thickness, and 1% to 24% improvement in size of the lesion. Eight patients with HOIs underwent surgery after laser therapy, and of these, 100% saw improvement in color, thickness, and size. Port-wine stains showed a 1% to 24% improvement in color and no improvement in thickness or size. Interrater reliability for questions 1 to 6 was 0.92, 0.92, 0.93, 0.91, 0.70, and 0.10, respectively.
  
  
  CONCLUSIONS
  Currently, no standardized or validated methods exist to evaluate results from intervention of pediatric facial HOIs and port-wine stains. Our assessment tool is reliable to assess patients with HOIs and port-wine stains who undergo pulsed-dye laser therapy and surgical reconstruction.
  
  
  METHODS
  3.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis.
authors.forename: Javad A
authors.initials: JA
authors.lastname: Sajan
authors.forename: Robert
authors.initials: R
authors.lastname: Tibesar
authors.forename: Noel
authors.initials: N
authors.lastname: Jabbour
authors.forename: Timothy
authors.initials: T
authors.lastname: Lander
authors.forename: Peter
authors.initials: P
authors.lastname: Hilger
authors.forename: James
authors.initials: J
authors.lastname: Sidman
mesh_terms: D006391:Hemangioma / Q000601:surgery*; D006801:Humans; D007223:Infant; D054025:Lasers, Dye / Q000627:therapeutic use*; D015588:Observer Variation; D017063:Outcome Assessment, Health Care / Q000379:methods*; D019339:Port-Wine Stain / Q000601:surgery*; D012189:Retrospective Studies; D016037:Single-Blind Method; D012878:Skin Neoplasms / Q000601:surgery*; D016896:Treatment Outcome