Experience With Recurrent Respiratory Papillomatosis in a Developing Country: Impact of Tracheostomy

Orji, Foster Tochukwu; Okorafor, Ijeoma A.; Akpeh, James O.

doi:10.1007/s00268-012-1839-y

Cited by 17 publications

(10 citation statements)

References 24 publications

(53 reference statements)

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“…3 In developing countries, as a result of the poor availability of healthcare services in general and ENT services in particular, [42][43][44] patients frequently present with upper airway obstruction and a history of hoarseness for many years. 3,4,30,40,41,[45][46][47][48][49][50][51] In a South African study, all patients diagnosed in the private sector had only hoarseness on initial presentation, while 70.1% of patients diagnosed in the public sector also presented with stridor, with 51.9% being in respiratory distress. 40 Pulmonary hypertension and cor pulmonale may rarely occur as a result of chronic upper airway obstruction.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…56 Tracheostomies are performed more frequently in developing countries as a result of the lack of expertise to manage patients with RRP. Case series from sub-Saharan Africa have reported tracheostomy rates of 20.3% in Kenya, 46 42-100% in Nigeria, [47][48][49] 47% in Mali, 50 and 50.8% in Senegal. 70 In a Bangladeshi study, 70% of patients with JoRRP required tracheostomies, 45 while studies from Thailand report a tracheostomy rate of 13.3-30%.…”

Section: Disease Coursementioning

confidence: 99%

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<p>Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management – A Developing Country Review</p>

Seedat

2020

PHMT

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Recurrent respiratory papillomatosis (RRP) is a condition caused by human papillomavirus (HPV), usually HPV types 6 and 11, which is characterized by recurrent papillomas of the respiratory tract, mainly the larynx. Patients usually present between the ages of 2 and 6 years. The initial presenting symptom is progressive dysphonia, followed by stridor and respiratory distress. Treatment consists of repeated microlaryngoscopic procedures to remove the papillomas as there is no cure. The poor availability and accessibility of appropriate healthcare services in developing countries are barriers to the early diagnosis and appropriate management of patients with juvenile-onset recurrent respiratory papillomatosis (JoRRP), requiring many patients to have a tracheostomy. The introduction of prophylactic vaccines that include HPV6 and HPV11 is necessary in order to reduce the incidence of JoRRP.

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Section: Clinical Presentationmentioning

confidence: 99%

Section: Disease Coursementioning

confidence: 99%

<p>Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management – A Developing Country Review</p>

Seedat

2020

PHMT

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“…Simptomi bolesti se uobičajeno ne javljaju u prvih šest meseci života i tegobe počinju kako papilomi rastu [9]. Kada se bolest javi u detinjstvu možemo očekivati da papilomi nastave sa rastom i u tinejdžerskim godinama [10]. U podacima iz literature nalazimo oprečne stavove o težoj formi respiratorne papilomatoze www.tmg.org.rs povezane sa HPV 11 tipom virusa.…”

Section: Discussionunclassified

Acute respiratory insufficiency caused by laryngeal papillomatosis

Knežević¹,

Gajović²

2018

Timočki medicinski glasnik

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Rekurentna respiratorna papilomatoza je retka bolest, najčešće lokalizovana u laringsu. Prevalenca je 1-4 obolelih na 100 000. Najčešće počinje u ranom detinjstvu i karakteriše je hronični, recidivantni i nepredvidiv tok. Humani papiloma virus tipovi 6 i 11 je uzročnik bolesti koja se manifestuje postepenim razvojem promuklosti, vizinga, hrkanja, dispnejom i osećajem stranog tela u guši. Prikazujemo kliničku sliku akutne respiratorne insuficijencije uzrokovane rekurentnom respiratornom papilomatozom, u martu 2017. godine kada je kod pacijenta došlo do naglog gušenja, cijanoze, ispiratornog stridora i borbe za vazduh. Učinjena je urgentna traheotomija i plasiran armirani tubus br 7 jer se nije imao uvid u nivo opstrukcije na potezu larings-račva traheje. Hospitalizovan je u jedinici intenzivnog lečenja, obezbeđenog vazdušnog puta i dobre saturacije. U uslovima opšte anestezije bronhoskopski fleksibilnim bronhoskopom odstranjen sluzavo-gnojni čep iz traheje, potom neposredno ispod otvora traheostome celom cirkumferencijom lumena viđene papilomatozne formacije koje lumen svode na 15%. Učinjena je konsekutivna mehanička rekanalizacija rigidnim tubusima sa ektrakcijom papiloma forcepsom. Nakon intervencije traheja je prolazna na oko 90% lumena. Pacijent potom stabilan, ubrzo otpušten, javljao se na kontrolnu bronhoskopiju nakon mesec dana kada je nalaz bio zadovoljavajući. Ovo je njegova 55. hospitalizacija zbog osnovne bolesti. Ponavljane traheotomije nose rizik od širenja virusne infekcije u traheju i pluća, ali su nekada neizbežne zbog neočekivane životne ugroženosti obolelih od papilomatoze laringsa. Ključne reči: rekurentna laringealna papilomatoza, humani papiloma virus, larings, traheotomija.

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“…Early decannulation is therefore recommended. 2,25 Adjuvant treatment is indicated in patients who require four or more surgical debulkings per annum, rapid recurrences of papilloma with short disease-free intervals and or distal spread of papilloma beyond the subglottis. 1,2 Adjuvant therapy is required in 12.6% and 47.6% of patients.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with severe recurrent respiratory papillomatosis

Khan

Naidu²

2019

Southern African Journal of Infectious Diseases

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The overall incidence of RRP has been determined in developed countries, and ranges from 0.6 per 100 000 to 2.13 per 100 000. The incidence in the United States is estimated at 4.3 per 100 000 Background: Recurrent respiratory papillomatosis can present with a highly variable clinical course. The disease can cause serious morbidity and can be fatal because of airway obstruction. We examined whether the age of onset, gender, human immunodeficiency virus (HIV) infection and dysplasia on analysis of histological specimens were predictive of an aggressive disease course. Objectives:To conduct an audit of all patients presenting with Recurrent Respiratory Papillomatosis at our institution and to determine if an earlier age of onset, gender, HIV and dysplasia are predictive factors for an aggressive disease course.Methods: A total of 202 clinical records and histological reports were reviewed at a quaternarylevel hospital in Durban, South Africa. The disease was defined as juvenile onset (< 18 years) or adult onset (≥ 18 years). Aggressive disease was defined as a disease requiring 10 or more surgical debulkings in total and or extralaryngeal papilloma.Results: A total of 184 patients were of juvenile onset and 18 were of adult onset. In the juvenile onset group, a total of 97 patients (52.8%) had aggressive disease. In the juvenile onset group, a later age of onset was associated with less aggressive disease (odds ratio [OR] = 0.77, p < 0.05). There were 20 (10.9%) HIV-positive patients. HIV infection was a predictor of aggressive disease (OR = 3, p < 0.029). Analysis of histological reports revealed that 39 (21.2%) of patients had dysplasia. Dysplasia was a predictor of aggressive disease (OR = 9.96, p < 0.05%). In the adult onset group, only two patients (11.1%) had aggressive disease. Conclusion:An earlier age of onset, HIV infection and dysplasia were predictors of aggressive disease in the juvenile onset group.

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Experience With Recurrent Respiratory Papillomatosis in a Developing Country: Impact of Tracheostomy

Abstract: Multiple laryngeal papillomatosis clearly followed a more severe and less predictable course than the solitary type in both groups. Although there was a high incidence of tracheostomy in this study, short-duration tracheostomies accounted for the low incidence of extralaryngeal spread.

Cited by 17 publications

References 24 publications

<p>Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management – A Developing Country Review</p>

<p>Juvenile-Onset Recurrent Respiratory Papillomatosis Diagnosis and Management – A Developing Country Review</p>

Acute respiratory insufficiency caused by laryngeal papillomatosis

Risk factors associated with severe recurrent respiratory papillomatosis

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