SURGICAL TREATMENT BURDEN AND DISEASE PROGRESSION CHARACTERISTICS OF RECURRENT RESPIRATORY PAPILLOMATOSIS
Main Article Content
Abstract
Background: Recurrent respiratory papillomatosis (RRP) is a benign airway disease caused by human papillomavirus (HPV) infection. It is characterized by recurrent papillomatous lesions of the larynx and a high tendency for recurrence requiring repeated surgical interventions. Although histologically benign, the disease may cause persistent hoarseness, airway obstruction and significant morbidity.
Objective: To describe the clinical characteristics and evaluate the surgical burden in patients with recurrent respiratory papillomatosis treated at Ho Chi Minh City Ear-Nose-Throat Hospital.
Methods: A case series study was conducted in patients diagnosed with RRP based on endoscopic findings and histopathology. Clinical variables including age, sex, presenting symptoms, lesion location, disease extent and number of surgical procedures during follow-up were collected. Descriptive statistical analysis was performed.
Results: Hoarseness was the most common presenting symptom among patients with RRP. Lesions were most frequently located at the glottic level, particularly along the free edge of the vocal cords. Due to the recurrent nature of the disease, many patients required multiple surgical procedures during follow-up. Patients with more extensive disease involving multiple anatomical sites tended to undergo a higher number of surgeries compared with those with localized lesions.
Conclusion: Recurrent respiratory papillomatosis is a chronic disease with a high recurrence rate, leading to substantial surgical burden. Early recognition of disease extent and long-term follow-up are essential for optimizing management strategies.
Keywords
Recurrent respiratory papillomatosis, laryngeal papilloma, HPV infection, laryngeal surgery
Article Details
References
2. ARMSTRONG, L. R., DERKAY, C. S. & REEVES, W. C. J. S. o. A. Initial Results from the National Registry for Juvenile-Onset Recurrent Respiratory Papillomatosis. 44, 92-93 (2000).
3. Ivancic, R., Iqbal, H., deSilva, B., Pan, Q. & Matrka, L. J. L. i. o. Current and future management of recurrent respiratory papillomatosis. 3, 22-34 (2018).
4. Mounts, P., Shah, K. V. & Kashima, H. J. P. o. t. N. A. o. S. Viral etiology of juvenile-and adult-onset squamous papilloma of the larynx. 79, 5425-5429 (1982).
5. Gissmann, L. et al. Human papillomavirus types 6 and 11 DNA sequences in genital and laryngeal papillomas and in some cervical cancers. 80, 560-563 (1983).
6. Doorbar, J. et al. The biology and life-cycle of human papillomaviruses. 30, F55-F70 (2012).
7. Reeves, W. C. et al. National registry for juvenile-onset recurrent respiratory papillomatosis. 129, 976-982 (2003).
8. Seedat, R. Y. & Schall, R. Age of diagnosis, incidence and prevalence of recurrent respiratory papillomatosis-A South African perspective. Clinical otolaryngology : official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 43, 533-537, doi:10.1111/coa.13016 (2018).
9. Best, S. R. et al. Safety and dosing of bevacizumab (avastin) for the treatment of recurrent respiratory papillomatosis. The Annals of otology, rhinology, and laryngology 121, 587-593, doi:10.1177/000348941212100905 (2012).
10. Dikkers, F. G., Tjon Pian Gi, R. E. A. & San Giorgi, M. R. M. in Infections of the Ears, Nose, Throat, and Sinuses (eds Marlene L. Durand & Daniel G. Deschler) 321-333 (Springer Nature Switzerland, 2024).