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Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation
Published on: November 10, 2023
Tracheal, bronchial, and pulmonary papillomatosis in children
Iouri L Soldatski1, Elena K Onufrieva, Andrei M Steklov
1Department of Otorhinolaryngology, IM Sechenov Moscow Medical Academy, Russia. ysoldatsky@aport.ru
Insights
Recurrent respiratory papillomatosis can spread to the lower airways, especially after tracheotomy in children. Lower airway papillomatosis has a more aggressive clinical course and poorer treatment outcomes compared to laryngeal papillomatosis.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
- Oncology
Background:
- Recurrent respiratory papillomatosis (RRP) is a rare disease characterized by the growth of papillomas in the respiratory tract.
- Laryngeal papillomatosis is the most common form, but extension to the lower airways can occur.
Purpose of the Study:
- To compare the clinical course of tracheal, bronchial, and pulmonary papillomatosis with laryngeal papillomatosis in children.
- To identify risk factors and outcomes associated with lower airway RRP.
Main Methods:
- Retrospective review of 448 children with RRP treated between 1988 and 2003.
- Analysis of patient demographics, surgical history, disease spread, and clinical course.
Main Results:
- Lower airway RRP occurred in 8.9% of cases, with pulmonary involvement in 20% of those.
- Tracheotomy was the primary cause of lower airway spread (92.5%).
- Lower airway RRP demonstrated a more aggressive course and lower treatment efficacy.
Conclusions:
- Children with laryngeal papillomatosis and a history of tracheotomy require vigilant endoscopic and imaging surveillance for potential lower airway involvement.
- The prognosis for pulmonary papillomatosis is serious, necessitating early detection and management.
Objectives:
To compare the clinical course of tracheal, bronchial, and pulmonary papillomatosis with clinical course of laryngeal papillomatosis in children.
Study Design:
The records of the 448 children with recurrent respiratory papillomatosis treated in St. Vladimir Moscow Children's Hospital between 1988 and 2003 were reviewed. In all cases, the diagnosis was confirmed histologically. Age at onset of symptoms, age at first surgery, number of surgical procedures, mean duration of surgical interval, possible causes, and age at a point of papillomatosis spread in the lower airways and course of the disease were analyzed.
Setting:
Academic children's hospital.
Results:
Papillomas extension down to lower airways was observed in 40 children (8.9%). Among 40 patients with lower airway recurrent respiratory papillomatosis, 8 (20%) demonstrated pulmonary involvement. The basic cause of papilloma extension to lower airways appeared to be tracheotomy performed in children with laryngeal papillomatosis (92.5% of cases). Incidence of satellite pharyngeal and esophageal papillomatosis is significantly higher in patients with lower airways papillomatosis, presenting evidence of lager process extension. The clinical course of lower airways papillomatosis is more aggressive as compared with laryngeal papillomatosis, and treatment efficacy in such children is lower.
Conclusions:
All the patients with laryngeal papillomatosis having a history of tracheotomy require a regular endoscopic control and chest radiographs or computed tomography scanning because tracheal or pulmonary papillomatosis may occur in such patients even several years after decannulation. The prognosis for the disease after development of pulmonary papillomatosis is always serious.
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