Distribution Characteristics of Juvenile-Onset Recurrent Respiratory Papillomatosis at First-Time Surgery

Abstract

Objectives The lesion distribution of juvenile-onset recurrent respiratory papillomatosis (JORRP) during first-time surgery has been rarely reported. The purpose of this study was to describe the anatomical distribution of papilloma across 25 Derkay sites during initial surgery and to assess the impact of the lesion distribution on disease severity. Methods Surgical videos and medical records of 106 patients with JORRP (27 aggressive and 79 nonaggressive cases) were retrospectively reviewed. Lesion locations were recorded using Derkay anatomical sites. Logistic regression was used to analyze the effect of the lesion distribution on disease severity. Results Among the 106 patients, the true vocal cords (90.6% left, 84.0% right) were the most frequently involved site, followed by the false vocal cords (39.6% left, 35.8% right) and the anterior commissure (26.4%). Two patients (1.9%) had tracheal involvement. Patients with false vocal cord involvement (odds ratio [OR] = 3.425, 95% confidence interval [CI] [1.285, 9.132], P = .014) and a younger age at diagnosis (OR = .698, 95% CI [.539, .905], P = .007) were more likely to require more than 4 procedures in the year following first-time surgery. Conclusions Lesions were most common on the true vocal cords. False vocal cord involvement and a younger age at diagnosis were risk factors for disease severity.

Characteristics of Recurrent Respiratory Papillomatosis and Impact Factors of Surgical Intervals

“…The recurrence trend in the JO-RRP group was significantly earlier than that in the AO-RRP group, and patients with JO-RRP usually had faster disease growth, were more likely to cause airway obstruction, and relapsed faster after treatment, which was consistent with the characteristics of RRP disease reported in the current literature. Bronchoscopy can directly visualize lesions of the lower respiratory tract while specimens are collected for histopathological examination [26] .For all patients with RRP in this study, disease involves the most common site of glottis, followed by supraglottic, consistent with previously reported results [27] .…”