Clinical investigation of carbon dioxide laser treatment for lingual leukoplakia

Objective: Previous studies have described the clinical statistics and treatment outcomes of leukoplakia of the oral cavity. However, because leukoplakia is often clinically diagnosed without any histopathological examination, current opinion regarding treatment methods and preoperative pathological diagnosis is inconsistent and no standard site-specific treatment guidelines exist for oral leukoplakia. The purpose of this study is to clinically evaluate carbon dioxide (CO₂) laser treatment for leukoplakia of the tongue. Methods: We examined 38 lesions in 35 patients of lingual leukoplakia who underwent CO₂ laser treatment with using Lugol staining at our department over a 10-year period, i.e., from 2001 to 2010. We investigated gender-related differences, age distribution, left and right differences, clinical classification, histopathological diagnosis (presence or absence of epithelial dysplasia), treatment technique (excision or evaporation), recurrence rate, residual rate, and malignant transformation among these cases. Results: Of the 38 lesions that fulfilled the inclusion requirements, 35 were excised and 3 were evaporated. After CO₂ laser treatment, the recurrence and residual rates for lingual leukoplakia were 10.5% and 7.9%, respectively. The recurrence rate of cases examined in this study was lower than that reported by our hospital previously (2004) and many other hospitals. None of the lesions exhibited malignant transformation. Conclusions: Our results suggest that the CO₂ laser excision method with using Lugol staining, as performed at our hospital, is useful for the treatment of lingual leukoplakia.