Abstract Background Recurrent respiratory papillomatosis is a rare but morbid disease caused by human papillomavirus (HPV) types 6 and 11. Infection is preventable through HPV vaccination. Following an extensive quadrivalent HPV vaccination program (females 12–26 years in 2007–2009) in Australia, we established a method to monitor incidence and demographics of juvenile-onset recurrent respiratory papillomatosis (JORRP) cases. Methods The Australian Paediatric Surveillance Unit undertakes surveillance of rare pediatric diseases by contacting practitioners monthly. We enrolled pediatric otorhinolaryngologists and offered HPV typing. We report findings for 5 years to end 2016. Results The average annual incidence rate was 0.07 per 100000. The largest number of cases was reported in the first year, with decreasing annual frequency thereafter. Rates declined from 0.16 per 100000 in 2012 to 0.02 per 100000 in 2016 (P = .034). Among the 15 incident cases (60% male), no mothers were vaccinated prepregnancy, 20% had maternal history of genital warts, and 60% were first born; 13/15 were born vaginally. Genotyped cases were HPV-6 (n = 4) or HPV-11 (n = 3). Conclusion To our knowledge, this is the first report internationally documenting decline in JORRP incidence in children following a quadrivalent HPV vaccination program.

Laryngeal amyloidosis remains a rare and clinically challenging condition. Diagnosis should be considered for unusual appearing submucosal laryngeal lesions. Treatment of this disease needs to be evaluated on a case-by-case basis and managed within an appropriate multidisciplinary team.

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Purpose of review Laryngeal amyloidosis is a rare hematological disorder of plasma cells. The cause is still considered idiopathic. The otolaryngology literature predominantly comprises case reports and short series. The present review summarizes the amyloid literature more generally in order to assist the otolaryngologist managing this disorder. Recent findings Distinguishing localized amyloidosis from systemic disease continues to be challenging. Both radiological and hematological investigations may assist. Surgery continues to be the predominant modality for treatment, but radiation and potentially medical approaches are on the horizon. Summary When localized, this benign laryngeal disease carries an excellent prognosis. Clinicians should however be aware of systemic presentations and ensure patients receive long-term follow-up.