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Recurrent Respiratory Papillomatosis

(Laryngeal Papillomas)

by Udayan K. Shah, MD

Recurrent respiratory papillomatosis is a rare noncancerous (benign) tumor of the respiratory system, commonly affecting the voice box (larynx).

Recurrent respiratory papillomatosis is caused by human papillomavirus. This tumor is most often diagnosed when it occurs in the voice box as laryngeal papillomas. Although laryngeal papillomas can occur at any age, they most commonly affect children aged 1 to 4 years.

Papillomas are suspected when parents notice hoarseness, a weak cry, or other changes in the child’s voice. Papillomas recur often and occasionally spread into the windpipe (trachea) and lungs, blocking the airway. Rarely, they become cancerous (malignant).

Laryngeal papillomas are detected using a laryngoscope to view the voice box. Doctors do a biopsy of the papilloma to confirm the diagnosis.

Although some tumors may begin to disappear at puberty, treatment is recommended. Surgical removal is the usual treatment. Many children require numerous procedures through childhood to remove the tumors as they reappear. Other treatments (such as pulsed-dye laser therapy or photodynamic therapy—see Using Lasers to Treat Skin Problems) as well as antiviral drugs (such as cidofovir) may be given to children who have a severe case.

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