Laryngeal papillomatosis

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Obesity, Sleep & Internal medicine
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Laryngeal papillomatosis
Synonyms	Recurrent respiratory papillomatosis
Pronounce	N/A
Specialty	N/A
Symptoms	Hoarseness, dyspnea, stridor, cough
Complications	Airway obstruction, respiratory distress
Onset	Childhood or adulthood
Duration	Chronic
Types	N/A
Causes	Human papillomavirus (HPV) types 6 and 11
Risks	HPV infection, immunosuppression
Diagnosis	Laryngoscopy, biopsy
Differential diagnosis	Vocal cord nodules, laryngeal cancer, laryngitis
Prevention	N/A
Treatment	Surgical removal, antiviral therapy, HPV vaccination
Medication	Cidofovir, bevacizumab
Prognosis	N/A
Frequency	Rare
Deaths	N/A

A rare medical condition affecting the larynx

Laryngeal papillomatosis is a rare medical condition characterized by the growth of benign tumors, known as papillomas, in the larynx, or voice box. These growths are caused by infection with the human papillomavirus (HPV), specifically types 6 and 11. The condition can lead to significant respiratory and voice problems due to obstruction of the airway and interference with normal vocal cord function.

Histopathology of a large squamous cell papilloma.jpg

Squamous papilloma -- very low mag.jpg

Pathophysiology

Laryngeal papillomatosis is caused by the human papillomavirus, which infects the epithelial cells of the larynx. The virus induces the proliferation of these cells, leading to the formation of papillomas. These growths are typically exophytic, meaning they grow outward from the surface of the larynx. The papillomas can vary in size and number, and they may recur frequently even after surgical removal.

Clinical Presentation

Patients with laryngeal papillomatosis often present with symptoms related to airway obstruction and voice changes. Common symptoms include:

• Hoarseness
• Dysphonia (difficulty speaking)
• Stridor (a high-pitched wheezing sound during breathing)
• Dyspnea (difficulty breathing)
• Chronic cough

In severe cases, the papillomas can cause significant airway obstruction, leading to respiratory distress and requiring urgent medical intervention.

Diagnosis

The diagnosis of laryngeal papillomatosis is typically made through a combination of clinical evaluation and direct visualization of the larynx. This is often accomplished using laryngoscopy, a procedure that allows for direct examination of the larynx and vocal cords. Biopsy of the lesions may be performed to confirm the diagnosis and rule out malignancy.

Treatment

The primary treatment for laryngeal papillomatosis is surgical removal of the papillomas. This can be done using various techniques, including:

• Microlaryngoscopy with cold instruments
• Laser surgery, such as CO2 laser or KTP laser

Despite surgical intervention, the papillomas often recur, necessitating repeated procedures. Adjuvant therapies, such as antiviral medications or immunotherapy, may be used to reduce the frequency of recurrences.

Prognosis

The prognosis for individuals with laryngeal papillomatosis varies. While the condition is benign, the recurrent nature of the papillomas can lead to significant morbidity. In rare cases, the papillomas may undergo malignant transformation into squamous cell carcinoma.

Epidemiology

Laryngeal papillomatosis is a rare condition, with an estimated incidence of 4.3 per 100,000 children and 1.8 per 100,000 adults. It is more common in children, where it is referred to as juvenile-onset recurrent respiratory papillomatosis (JORRP). Adult-onset recurrent respiratory papillomatosis (AORRP) occurs less frequently.

See also

• Human papillomavirus
• Laryngoscopy
• Respiratory system
• Vocal cords

External links

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