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Tool reliably assessed PDL treatment of pediatric facial vascular anomalies

An assessment tool reliably assessed results of patients with pediatric facial hemangiomas of infancy and port-wine stains who underwent pulsed-dye laser therapy in a recent study.

Researchers conducted a retrospective chart review of 22 pediatric patients with facial vascular anomalies (17 hemangiomas of infancy, HOIs; five port-wine stains) who were treated with 595-nm cool-tip pulsed-dye laser (PDL) therapy at a tertiary care hospital. Three masked pediatric otolaryngologists and facial plastic surgeons used a six-question assessment tool developed by the researchers to rate pretreatment and posttreatment photographs. Reviewers were asked to quantify changes in size, color, thickness, scaring, hypopigmentation and atrophy.

Patients had 79 cumulative laser treatments, with average age at treatment start of 10 months. PDL treatment was applied to the upper lip, lower lip, nasal tip, nasal ala, upper eyelid, cheek, forehead and temple. Patients with HOIs treated with PDL showed an average improvement of 50% to 75% in color and 1% to 24% for thickness and lesion size. Eight patients with HOIs who underwent surgical reconstruction after PDL therapy had 100% improvement in color, thickness and size of HOIs. While patients with HOIs who underwent PDL only showed no scarring, patients treated with PDL and surgery experienced scarring.

Patients with port-wine stains displayed a 1% to 24% improvement in color, but no change in thickness or lesion size after PDL treatment.

Assessment questions had interrater reliability of 0.92, 0.92, 0.93, 0.91, 0.7 and 0.1. Scores greater than 0.7 were usually considered acceptable.

“Currently, no standardized or validated methods exist to evaluate results from intervention,” the researchers concluded. “Our tool is a consistent rating system that shows agreement among raters to detect change in color, size, thickness, scarring and atrophy in HOIs and port-wine stains treated with PDL.”

Disclosure: The researchers report no relevant financial disclosures.