ObjectTo illuminate the salivary gland acinar with different energy Er:YAG laser,observe the morphological changes of the acinar under the light microscope,define the effect of laser on the morphology of the acinus,and further validate the laser treatment of oral mucus from experimental pathology.The rationality of glandular cysts provides a basis for clinical application.On the other hand,a clinical study was conducted to compare the intraoperative conditions,postoperative complications,and clinical efficacy of Er:YAG/Nd:YAG laser treatment with traditional surgical methods for the treatment of oral mucinous cysts,and combined with experimental studies for the treatment of oral cavity Small mucinous cysts look for an effective,safe,comfortable,minimally invasive method.Methods1.Experimental study a total of 42 patients(21 in the lip,18 in the tongue,and 3in the cheek)who were admitted to the Department of Stomatology at the First Affiliated Hospital of Shihezi University in Xinjiang from September 2016 to November 2017 were collected.Forty-two patients were surgically removed from the cyst and surrounding acini.Three pieces of uniform acinar tissue were removed from each specimen.According to the different laser energy(1W,2W),the three acinar tissues of each patient were divided into blank control group,1W group and 2W group.Laser irradiation was performed within 10 minutes and then placed in 4%.Neutral formaldehyde was retained,and the collected specimens were regularly made into wax blocks,sectioned,and stained with HE.The morphological observation and counting were performed by light microscopy.2.Clinical study collected 76 cases of oral mucinous cysts from June 2016 to November 2017 in the Department of Stomatology,First Affiliated Hospital of Shihezi University.Among them,42 cases were treated by surgery and 34 cases were treated by surgery.For laser treatment.A total of five cases were lost to follow-up.The actual number of cases was 71,with 43 males and 28 females.According to the different treatment methods,they were divided into Er:YAG/Nd:YAG laser group and operation group.Er:YAG/Nd:YAG laser group(32 cases): Er:YAG laser planing treatment + Nd:YAG laser hemostasis;surgical group(39 cases): cyst + surrounding glands removed.Results1.Morphological observation(1)Control group: The mucous cells were observed to be triangular or cone-shaped under the light microscope.The cytoplasm was transparent and net-like structure.The lattice was composed of cytoplasm and precipitated viscogenous,slightly basophilic and pale.Blue staining.(2)1W group: There was no significant change in the number of acinar cells.There was atrophy of some acini in the field of vision.There was no necrotic acinar cells.No changes were observed in the morphology and acini of the remaining acinar vesicles.(3)2W group: A large number of acinar cells were seen to be smaller in size,and the number was decreased.The gap between the acini was increased.Even a few acinar cells were found to be necrotic under high magnification.The necrotic cells became smaller and the nuclei showed pyknosis and fragmentation.The cytoplasm is dark blue or blue-black.2.Counting results(1)Atrophic atrophy and atrophy rate were higher in the 1W and 2W groups than in the blank control group;(2)Atrophic atrophy numbers in the 2W group(88.60±3.44)were significantly higher than in the 1W group(50.31±4.06)The difference was statistically significant(P<0.05).The atrophic rate of acinar in the 2W group was(87.91±2.52)% significantly higher than that in the 1W group(51.24±3.70)%.Acinar atrophy was observed between the two groups.The difference was statistically significant(P<0.05).3.Comparison of intraoperative conditions: operative time(16.25±1.68)min in the Er:YAG/Nd:YAG laser group was significantly shorter than that in the surgical group(27.26±2.71)min,and the difference was statistically significant(P<0.05);Er: In the YAG/Nd:YAG laser group,there were almost no hemorrhages in 32 patients.In the surgical group,33 patients had bleeding in 33 cases.The difference between the two groups was statistically significant(P<0.05).4.Postoperative observations of results The Er:YAG/Nd:YAG laser group performed 32 postoperative complications in 3 patients.In the surgical group,postoperative edema occurred in 10 of 39 patients,and postoperative scar formation in 9 patients.There was a statistically significant difference between groups(P<0.05);however,there was no significant difference in the incidence of postoperative recurrence(P>0.05);the wound healing time was significantly shorter in the Er:YAG/Nd:YAG laser group than in the surgical group.Statistically significant(P<0.05).5.Efficacy comparison Er:YAG/Nd:YAG laser group total effective rate(75.00)%,surgery group(83.34)%,there was no significant difference between the two groups(P> 0.05).6.According to the most obvious sign of pain within 3 days after operation,the results of VAS showed that there was a statistically significant difference in pain between the two groups(P<0.05).Conclusion1.Er:YAG laser irradiation did not cause atrophy when irradiated with acini,and the number of acinar cells with increasing atrophy increased,and a few acinar cell necrosis was seen.It is inferred that when the laser is adjusted to a certain energy according to the intraoperative conditions,the purpose of completely eliminating the diseased tissue and the affected acinar can be achieved;2.Er:YAG laser is set to SP mode,mobile phone R11,local energy density: 4.3J/cm2,frequency 15 Hz for the treatment of small oral mucinous cyst planing,can safely and effectively eliminate lesions and involved acini;3.Er:YAG/Nd:YAG laser treatment and surgical treatment of small mucinous cysts in the mouth,no difference in efficacy,Er:YAG/Nd:YAG laser treatment without anesthesia and suture,simple operation,short operation time,Less bleeding,faster wound healing,less postoperative complications,less scar formation,less pain,less pain,and improved treatment comfort;4.The use of Er:YAG/Nd:YAG laser for long duration and repeated cyst recurrence or pediatric patients is safer and more effective.For patients with tongue cysts,surgical resection should be performed.During the operation,the operation should be performed gently.After the operation,the patient should be careful to prevent infection. |