Recurrent laryngeal papillomas

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Recurrent Laryngeal Papillomas
Other names	Laryngeal Papillomatosis, Juvenile Laryngeal Papillomatosis

Recurrent Laryngeal Papillomas (RLP), also known as Laryngeal Papillomatosis, is a rare, non-cancerous disease characterized by the growth of papillomas (benign tumors) on the larynx (voice box) and, in some cases, the trachea (windpipe). The condition is caused by the Human Papillomavirus (HPV), particularly types 6 and 11. RLP is most commonly seen in children (Juvenile Laryngeal Papillomatosis) but can also affect adults.

Symptoms

Symptoms of RLP include:

• Hoarseness
• Difficulty breathing (dyspnea)
• Chronic cough
• Recurrent respiratory infections

In severe cases, the papillomas can cause significant airway obstruction, leading to life-threatening breathing difficulties.

Causes

RLP is caused by the Human Papillomavirus (HPV), with types 6 and 11 being the most commonly associated strains. The virus is believed to be transmitted from mother to child during childbirth, although adult-onset cases suggest other modes of transmission, such as oral-genital contact.

Diagnosis

Diagnosis of RLP involves a combination of:

• Medical history and physical examination
• Laryngoscopy - a procedure that allows a doctor to look at the larynx using a small, flexible tube with a light and camera
• Biopsy of the papillomas for histopathological examination

Treatment

Treatment options for RLP include:

• Surgical removal of the papillomas, often requiring multiple procedures due to the recurrent nature of the disease
• Laser therapy for the removal of papillomas
• Antiviral therapy with agents such as cidofovir, although its use is controversial due to potential side effects
• Voice therapy to help manage symptoms and improve voice quality

Prognosis

The prognosis for individuals with RLP varies. While the condition can be managed with treatment, it is often recurrent, requiring multiple interventions. In rare cases, RLP can progress to squamous cell carcinoma, a type of cancer.

Prevention

Prevention of RLP focuses on the prevention of HPV infection. The HPV vaccine is effective in preventing infection with HPV types 6 and 11 and is recommended for both boys and girls.

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