Laryngeal sequelae of recurrent respiratory papillomatosis surgery in children

Abstract

Laryngeal sequelae are a frequent complication of recurrent respiratory papillomatosis surgical treatment in children, particularly anterior commissure synechiae and glottic stenosis. Advanced stages are associated with increased risk of laryngeal sequelae after surgery.

Prevalence, clinical presentations, associated risk factors and recurrence of laryngeal papillomatosis among inpatients attended at a Tertiary Hospital in Northern zone Tanzania

“…Similar observations were found in our study in which under 5 year patients had the highest prevalence while the adolescent age group (15-19 years) had the lowest prevalence 1 (2%), this can possibly be due to the fact that laryngeal papillomatosis tends to subside at this age or upon attaining puberty. Although most of the studies show males to be more affected [3,4,7,8], our study showed that females are more affected 11 (57.9%) than males 8(42.1%) for patients under 5years and in AOLP in which females were 4 (57.1%) while males 3 (42.9%), other age groups agree with findings from the previous studies. However, generally males have high prevalence in JOLP as well as AOLP.…”

“…It is termed laryngeal papillomatosis or glottal papillomatosis due to the strong predilection for the larynx but papillomas may present anywhere along the respiratory tract [1-3]. Although laryngeal papillomatosis is a rare disease [4] its highly recurrent nature and involvement of the airways upturns its burden to patients and the community [5,6] and it is slightly more prevalent in males [3,4,7-9]. As a result of airway obstruction, laryngeal papillomatosis is commonly misdiagnosed as asthma, bronchitis, laryngeal nodule or croup leading to late diagnosis and acute airway complications [10,11], of which some requiring tracheotomy for immediate breathing and further airway management [12].…”

“…As a result of airway obstruction, laryngeal papillomatosis is commonly misdiagnosed as asthma, bronchitis, laryngeal nodule or croup leading to late diagnosis and acute airway complications [10,11], of which some requiring tracheotomy for immediate breathing and further airway management [12]. While diagnosis is based on the clinical symptoms, nearly 100% of patients present with hoarseness followed by dyspnea [3,4], however this is not always as some patients may not present with hoarseness [7] and others present in a variety of combinations of clinical feature [13]. A clear understanding of the clinical course and features is thus required in order to distinguish it from other airway obstructive diseases.…”

“…However, as laryngeal papillomatosis involves respiratory system misdiagnosis or delayed diagnosis will predispose to emergency airway obstruction or longstanding complications due to inadequate gaseous exchange [17]. Most of the reviewed literatures from countries other than Tanzania seem to underestimate the prevalence of LP when applied to the northern zone of Tanzania, as they report the prevalence to be in a range of 0.002% [3] to 0.005% [7] whereas KCMC receive an approximate of more than 15 patients per year; these differences may impair the correct planning for health needs as far as LP is concerned. The aim of the study was to determine the prevalence, clinical presentations and recurrence, and describe the clinical triad of risk factors for laryngeal papillomatosis among patients attending ENT department at Kilimanjaro Christian Medical Center from 2005 to 2015.…”

Recurrent respiratory papillomatosis: current and future perspectives

“…Despite the adoption of more advanced surgical equipment, laryngeal sequelae still remain frequent complications, with anterior commissure synechiae and glottic stenosis frequently observed in children who have undergone multiple procedures, particularly in advanced stages. 45 – 47 …”