Laryngeal papillomatosis or recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV), with HPV 6 and HPV 11 accounting for 90% of cases.
Laryngeal papillomatosis occurs when benign tumors called papillomas grow in the larynx. Though there are more than 150 types of HPV, they do not all have the same symptoms.
Most people who encounter HPV never get affected by a related illness. However, a small number of people exposed to the HPV 6 or 11 virus develop laryngeal papillomas and genital warts.
Although scientists do not know what exactly causes the illnesses in some people, the virus is thought to be spread through sexual contact or through childbirth, when a mother with genital warts passes the virus to her baby.
Who is affected by laryngeal papillomatosis?
Laryngeal papillomatosis can occur in both adults and young children.
According to the estimates provided by the Centers for Disease Control and Prevention (CDC), laryngeal papillomatosis affects 2 in 100,000 children under age 18. In the United States, laryngeal papillomatosis affects 2-3 in 100,000 adults.
What are signs and symptoms of laryngeal papillomatosis?
The most common symptom of laryngeal papillomatosis is progressive hoarseness.
Additional symptoms include:
How is laryngeal papillomatosis diagnosed?
In order to diagnose laryngeal papillomatosis, your doctor will assess your symptoms, medical history, and head and neck during a physical examination. Based on their findings, they may order one or more of the following tests:
- Laryngeal videostroboscopy: Involves inserting a flexible or rigid tube called an endoscope, which is attached to a video monitor and light source, to assess the function and vibration of the larynx.
- Direct laryngoscopy or microlaryngoscopy: Allows your doctor fully examine the vocal folds with high magnification. During the procedure, a biopsy may be performed, in which a sample of tissue is removed to check for inflammation or cancer cells.
How is laryngeal papillomatosis treated?
Currently, there is no cure for laryngeal papillomatosis. First-line treatment involves surgery to remove the tumors from the larynx. While this can be done via traditional surgical methods, laser surgery is preferred because traditional surgery has the potential to cause scarring of the larynx.
The recurrence rate of the tumors in laryngeal papillomatosis is high. As a result, multiple surgeries may be required.
If your doctor finds that the laryngeal papilloma is growing aggressively, a surgical procedure called tracheotomy may be performed. Tracheotomy involves making an incision in the front of the neck and inserting a breathing tube (endotracheal or ET tube) through the opening into the trachea. This allows the patient to breathe through the ET tube instead of through the mouth and nose.
In severe cases,medications may be administered before or after the surgery.:
- Interferon and cidofovir, which are antivirals
- Indole-3-carbinol, which is a cancer-fighting agent
- Bevacizumab, which is a medication that limits the growth of blood vessels that feed the papilloma
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Harman EM. Recurrent Respiratory Papillomatosis. Medscape. https://emedicine.medscape.com/article/302648-overview#
National Institutes of Health. Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis. https://www.nidcd.nih.gov/health/recurrent-respiratory-papillomatosis
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