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

Abstract

IntroductionAlthough Laryngeal papillomatosis is a rare disease and can be conventionally managed through surgical excision as well as adjuvant therapy yet Laryngeal papillomatosis has high tendency to recur raising its prevalence in the community, airway involvement warrants dangerous complications requiring emergency tracheostomy, especially if clinical course is poorly understood and misdiagnosis is common. The study aims to determine the prevalence, clinical features, risk factors and recurrence of Laryngeal Papillomatosis among patients attending ENT department at KCMC from 2005 to 2015.MethodsThis was a 10 year experience/ Descriptive hospital based cross-sectional study conducted based on patients' medical record at KCMC. Information was recorded into data collection sheets, entered and analyzed through SPSS version 20, summarized and presented in tables and charts, proportions and percentage used to compare groups.Results51 patients were identified over the 10 years study period corresponding to a prevalence of 0.09%. 26 were males and 25 females, ages ranging from 1 to 67 years. The median age of onset was 6 years. Children less than 5 years accounted for 19 (37.3%) and 58.8% had repeated surgeries. Clinical presentation ranged from hoarseness in 43 (84.3%) patients to weight loss 3 (5.9%) and 96.1% showed complete or partial presence of the clinical triad of risk factors.ConclusionLaryngeal papillomatosis is a rare disease that carries severe morbidity due to its highly recurring nature. It is primarily a paediatric disease, generally affecting more males; its clinical features highly resemble other airway obstructive diseases and therefore a careful thorough clinical evaluation is required in order to correctly diagnose Laryngeal papillomatosis.

Etiology, Clinical Profile, Evaluation, and Management of Stridor in Children

“…There were 3 cases with mean age of 4.7 y, who presented with complaints of inspiratory stridor, hoarseness, and progressive respiratory distress. In the study by James et al the median age of onset was 6 y [ 17 ]. Flexible laryngoscopy showed multiple grapes-like lesions in vocal cord (Fig.…”

HPV and Recurrent Respiratory Papillomatosis: A Brief Review

“…Another initial symptom is progressive dysphonia, which is also more frequent in adults [22,41]. Due to upper airway involvement, dyspnea, chronic cough, recurrent upper respiratory infections, pneumonia, acute respiratory distress, dysphagia, and/or failure to thrive may be present [41,42]. In addition, presence of HPV genomic sequences has been reported in the nasal cavity [43].…”

An updated review of the epidemiological factors associated with recurrent respiratory papillomatosis

“…The definitive risk factors for RRP remain unclear; however, both maternal and patient‐specific factors may play a role in disease contraction. Several known risk factors include maternal HPV infection at time of birth, vaginal delivery, teenage mother, and first born child 7‐9 . In addition to mother‐to‐child transmission during birth, RRP may be acquired through sexual contact.…”

“…In addition to mother‐to‐child transmission during birth, RRP may be acquired through sexual contact. Compared with disease‐free controls, patients with RRP have a significantly higher median number of lifetime sexual partners 7 . However, additional studies investigating sexual behavior as a risk factor have mixed findings 8 .…”

“…RRP has a wide range of clinical presentations. It most commonly presents with hoarseness, mild respiratory distress, loss of voice, mouth breathing, foreign body sensation, stridor, and snoring 7,13‐15 . Interestingly, dysphonia is more commonly seen in adults than children 14 .…”