Risk factors for severity of juvenile-onset recurrent respiratory papillomatosis at first endoscopy

Moreddu, E.; Lambert, Eddy; Kacmarynski, Deborah S. F.; Nicollas, R.; Triglia, J.-M.; Smith, Richard J.H.

doi:10.1016/j.anorl.2018.11.007

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…14 Lesion distribution characteristics are closely related to recurrence and may affect the clinical course of the disease. 7,15 However, many previous studies on lesion descriptions were performed decades ago, only tangentially address this topic, and fail to capture the natural lesion distribution. 8 Therefore, investigating the distribution of initial JORRP lesions and its clinical relevance are imperative.…”

Section: Discussionmentioning

confidence: 99%

“…10 Moreddu et al analyzed the effect of the lesion distribution in the 3 regions of the larynx on disease severity at first endoscopy; however, the lesion distribution was not discussed in detail. 7 Yao et al described the anatomical distribution of JORRP in different periods, but only described the distribution in the larynx, but did not describe the extra-laryngeal sites. 11 Thus far, the lesion distribution in patients with JORRP at first-time surgery is still unknown.…”

Section: Introductionmentioning

confidence: 99%

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

Xiao

et al. 2021

Ear Nose Throat J

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Xiao

et al. 2021

Ear Nose Throat J

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“…64,67 Involvement of multiple levels of the larynx or subglottis at initial laryngoscopy is associated with more severe disease. 68 On histology, while the degree of dysplasia has not been found to be associated with more severe disease, the presence of atypical mitoses and mitoses above the basal cell layer of the epithelium have been found to be associated with more severe disease. 69 A maternal history of condyloma acuminata may be associated with aggressive RRP.…”

Section: Disease Coursementioning

confidence: 98%

<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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“…RRP affects both adults and children and at times involves a life‐long disease burden. RRP is estimated to affect 1.8 per 100 000 adults and 4.3 per 100 000 children in the United States with a balanced sex ratio 2,4 . The average age at diagnosis for juvenile onset RRP (JORRP) is 5 years old while adult onset RRP (AORRP) is 37 4,5 .…”

Section: Epidemiological Factorsmentioning

confidence: 99%

“…RRP is estimated to affect 1.8 per 100 000 adults and 4.3 per 100 000 children in the United States with a balanced sex ratio 2,4 . The average age at diagnosis for juvenile onset RRP (JORRP) is 5 years old while adult onset RRP (AORRP) is 37 4,5 . RRP is typically considered juvenile onset when it is acquired at birth from mother‐to‐child transmission, while adult onset RRP typically involves sexual transmission of HPV 6 …”

Section: Epidemiological Factorsmentioning

confidence: 99%

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

Welschmeyer

Berke

2021

Laryngoscope Investig Oto

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Objectives To identify studies evaluating the epidemiology of recurrent respiratory papillomatosis (RRP), including patient demographics, human papillomavirus (HPV) immunology, clinical course, surgical and medical treatments, and psychosocial factors. Methods A systematic literature search through PubMed was performed to identify studies evaluating the epidemiological factors associated with RRP. All studies were screened through a priori selection criteria using the titles and abstracts. Results A total of 208 studies were identified, of which 54 met eligibility criteria and were included in the review. Conclusions RRP is a rare disease most commonly caused by HPV 6 and 11. It is characterized by recurring benign papillomatous lesions in the respiratory tract, particularly the larynx. Existing evidence about disease risk factors is limited but includes both maternal HPV infection and patient smoking and sexual behaviors. Disease management involves a combination of routine surgical and medical treatment. Surgical techniques include CO2‐laser, sharp dissection, coblation, microdebridement, and photoangiolytic laser. Medical treatments which have been found to facilitate disease control off‐label include interferon‐alpha (IFN‐α), indole‐3‐carbinol, acyclovir, bevacizumab, retinoids, and the Gardasil and mumps vaccines. Many patients suffer from additional psychosocial challenges related to their diagnosis. Current disease knowledge remains limited, and more robust controlled trials about risk factors, medical therapies, and surgical options are needed. Level of Evidence 5.

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Risk factors for severity of juvenile-onset recurrent respiratory papillomatosis at first endoscopy

Cited by 9 publications

References 21 publications

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

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

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

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

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