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

Abstract

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.

An Experimental Model of Human Recurrent Respiratory Papillomatosis: A Bridge to Clinical Insights

“…Diagnostics of RRP was based on the following criteria: (1) patients' complaints about permanent or recurrent hoarseness, (2) typical clinical signs of papillomas revealed during video laryngostroboscopy and direct microlaryngoscopy (exophytic, “cauliflower” shape appearing, sessile or pedunculated growths—pale pink with grayish tint, friable that tend to bleed at the least touch), 11‐13 and (3) histological identification of multiple “fronds” or finger‐like structures with a central vascular–connective core covered with stratified squamous epithelium and an intact basement membrane 11,21 . The final diagnosis of RRP was confirmed after histological examination of removed tissues at the Department of Pathology of LUHS.…”

“…Currently, there is no curative treatment for RRP, and therefore, the main treatment option for RRP is surgical intervention primarily focused on maintaining airway patency and voice quality; often, multiple surgeries over a short period of time are required 11‐13 …”

Recurrent respiratory papillomatosis: A 2020 perspective

“…Implementation of HPV vaccination programs in countries within the developing world may have the most profound effect on RRP eradication due to a higher incidence of JO RRP in low resource nations 34 . Despite the higher incidence of disease burden, many low income and middle‐income countries have not introduced the HPV vaccine as part of their national routine vaccination schedule 35 .…”

A Patient with Juvenile Recurrent Respiratory Papillomatosis Complicated by Laryngeal Stenosis after Laryngeal Microsurgery: A Clinical Case

“…Laryngeal papillomatosis is one of the global problems in the field of laryngology, since the exact etiopathogenesis of the disease is still not known. It is believed that about 10-60% of the world's population is infected with the human papillomavirus (HPV) latently, but not all get laryngeal papillomatosis, the causative agent of which is type 11 and 16 of this virus [1]. Juvenile respiratory laryngeal papillomatosis suggests that infection occurs secondarily, through the natural birth canal of the mother.…”

“…Only 3.3% of cases had lung damage. At the same time, the incidence of lung cancer among these patients was 16% [1]. It is also very rare to detect isolated papillomatosis of the trachea and lungs without involving the larynx [5].…”