Anatomically, HPV11-associated RRP behaves more aggressively. Younger patients with HPV11 and older patients with HPV6 experience a worse clinical course of RRP.

ObjectiveRecurrent respiratory papillomatosis (RRP) is a rare disease for which a limited number of information sources for patients exist. The role of the Internet in the patient–physician relationship is increasing. More and more patients search for online health information, which should be of good quality and easy readable. The study aim was to investigate the quality and readability of English online health information about RRP.Study DesignQuality and readability assessment of online information.MethodsRelevant information was collected using three different search engines and seven different search terms. Quality was assessed with the DISCERN instrument. The Flesch Reading Ease Score (FRES) and average grade level (AGL) were determined to measure readability of the English websites.ResultsFifty‐one English websites were included. The mean DISCERN score of the websites is 28.1 ± 9.7 (poor quality); the mean FRES is 41.3 ± 14.9 (difficult to read); and the mean AGL is 12.6 ± 2.3.ConclusionThe quality and readability of English websites about RRP is alarmingly poor.Level of EvidenceNA. Laryngoscope, 127:2293–2297, 2017

Distribution of age of onset of RRP shows three peaks. In addition to the already adopted idea of age peaks at paediatric and adult age, there is an additional peak around the age of 64.

4. Laryngoscope, 127:1826-1831, 2017.

Aim of this study was to explore influence of the quadrivalent HPV vaccine (Gardasil®) on the immune status of recurrent respiratory papillomatosis (RRP) patients. In retrospective observational study, six RRP patients who received the quadrivalent HPV vaccine and whose HPV seroreactivity was measured were included. Multiplex HPV Serology was used to determine HPV-specific antibodies pre- and post-vaccination. Surgical interventions and patient records were analyzed. Five HPV6 and 1 HPV11 infected patient were included. Mean antibody reactivity against the associated HPV type rose from 1125 median fluorescence intensity (MFI) pre-vaccination to 4690 MFI post-vaccination (p < 0.001). Median post-vaccination follow-up was 4 years. Poisson regression analysis showed that the quadrivalent HPV vaccine decreased the incidence rate of surgeries. The immune system of RRP patients is able to increase antibody reactivity against the associated HPV type. A double blind randomized controlled trial is needed to determine whether this immunological increase can cause decrease in number of surgeries.

The majority of sexually active individuals becomes infected with human papillomavirus (HPV) at least once in their lifetime. Pathways for HPV transmission vary across different mucosal sites per individual. They include autoinoculation within one host, direct transmission between individuals (including perinatal transmission and transmission during sexual activity), and indirect transmission through contact with hands. The authors aim to clarify the prevalence and route of transmission per anatomic site, inter-and intra-individually, using a narrative review of the literature.In conclusion, transmission of HPV to the oral cavity and oropharynx is hypothesised to occur mainly through sexual contact. Transmission of particles through saliva has not been proven and daily living activities are not a documented source of HPV infection. Oropharyngeal HPV related cancer survivors and their partners do not show increased risk of infection during sexual intercourse. Transmission of HPV to the oral cavity (autoinoculation with fingers or transmission through saliva in deep kissing) is probably of limited importance. K E Y W O R D S extragenital → extragenital, extragenital → genital, genital → extragenital, genital → genital, human papilloma virus, mucosal squamous cell carcinomas, orogenital transmission concerns 1 | INTRODUCTION This article will review the known pathways of transmission and clearance of oral human papilloma virus (HPV) infection. The problem of orogenital transmission concerns very sensitive personal spheres of life and is therefore often unexplored in literature. Furthermore, the literature data on the upper airway clearance mechanisms are still scarce and scattered. In this article we describe the risk of HPV transmission to the oropharynx per pathway (autoinoculation, perinatal transmission, inter-site transmission between individuals) as well as the prevalence of simultaneous occurrence of the same type of HPV in different anatomical sites in sexual partners (concordance).A significant proportion of mucosal squamous cell carcinomas of the head and neck, particularly of the oropharynx, are directly attributable to the HPV. 1,2 HPV infection is considered the most common sexually transmitted disease among both males and Abbreviations: DNA, deoxyribonucleic acid; HIV, human immunodeficiency virus; HPV, human papilloma virus; HPV-OPC, human papilloma virus associated oropharyngeal carcinoma; HR-HPV, high-risk human papilloma virus; LR-HPV, low-risk human papilloma virus; MHC, major histocompatibility complex; MMP-8, matrix metallo-proteinase-8; OPC, oropharyngeal carcinoma; RRP, recurrent respiratory papilloma.

There is insufficient proof that GERD does or does not aggravate the clinical course or tissue properties of RRP. Laryngoscope, 126:2330-2339, 2016.

Objective There is no specific clinical tool for physicians to detect psychosocial and physical distress or health care need in patients with recurrent respiratory papillomatosis (RRP). The main aim of this study is to validate the RRP-adapted Distress Thermometer and Problem List (DT&PL). Study Design Prospective cross-sectional questionnaire research. Setting Academic tertiary care medical centers in Groningen, Netherlands, and Helsinki, Finland. Subjects and Methods Ninety-one juvenile- and adult-onset RRP patients participated from the departments of otorhinolaryngology-head and neck surgery of the University Medical Center Groningen, Netherlands, and Helsinki University Hospital, Finland. The Hospital Anxiety and Depression Scale was used as the gold standard. Results A DT cutoff score ≥4 gave the best sensitivity and specificity. Thirty-one percent of patients had significant distress according to the DT cutoff. Significantly more patients with a score above than under the cutoff had a referral wish. The PL appeared to be reliable. Patients' opinions on the DT&PL were largely favorable. Conclusion The Dutch and Finnish versions of the DT&PL are valid, reliable screening tools for distress in RRP patients.