Recurrent respiratory papillomatosis is a rare, benign, viral airway tumor that is caused by the human papillomavirus. The most common way for patients to present is with laryngeal papillomas. Diagnosis includes laryngoscopy and biopsy. Treatment is excision.
Recurrent respiratory papillomatosis most often occurs in the larynx as laryngeal papillomas. Laryngeal papillomas can occur at any age but are most common at ages 1 to 4 years. They may reappear after treatment, undergo malignant transformation, and/or occasionally spread to the trachea or lungs.
Symptoms and Signs
Symptoms of recurrent respiratory papillomatosis can include weak cry, hoarseness, and, in severe cases, airway obstruction.
Diagnosis
Laryngoscopy
Biopsy
The tumor is identified by laryngoscopy. Recurrent respiratory papillomatosis may be a solitary lesion or it may manifest as multiple lesions. The diagnosis of recurrent respiratory papillomatosis is confirmed by biopsy.
Treatment
Excision
Treatment of recurrent respiratory papillomatosis is by excision. Because tumors may recur in weeks or months, multiple procedures may be required and surveillance by laryngoscopy and bronchoscopy is necessary. Surgery may involve pulsed-dye laser therapy or photodynamic therapy.
1). Lesions may regress at puberty in some patients. The quadrivalent human papillomavirus vaccine offers hope of prevention, but efficacy has not yet been proved.
Treatment reference
1. Derkay CS, Bluher AE: Update on recurrent respiratory papillomatosis. Otolaryngol Clin North Am 52(4):669–679, 2019. doi: 10.1016/j.otc.2019.03.011
