Adjuvant antiviral therapy for recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis is a condition characterised by benign papillomatous (wart-like) growths in the upper airway. It can affect both adults and children causing airway-obstruction and voice change. Treatment usually involves repeated surgical debulking of the papillomata, and several agents have been proposed as adjuvants to surgical debulking. These include antivirals, administered systemically or injected into the lesions.

To assess the effectiveness of antiviral agents as adjuvant therapy in the management of recurrent respiratory papillomatosis in children and adults.

We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2004), MEDLINE (January 1966 to November 2004), and EMBASE (January 1985 to November 2004) in December 2004. We checked reference lists of articles, contacted pharmaceutical companies and contacted leading experts in the field for further studies.

All randomised controlled trials.

One hundred references were identified from the searches. Twenty-five were appropriate for retrieval and assessed for eligibility by the authors. None met the inclusion criteria.

No controlled trials were identified.

There was insufficient evidence from controlled trials on which to base reliable conclusions about the effectiveness of antiviral agents as adjuvant therapy in the management of recurrent respiratory papillomatosis. Further research is required before any specific antiviral adjuvant therapy can be recommended.