Recurrent respiratory papillomatosis: a review

Area of Science:

• Otolaryngology
• Pediatric Oncology
• Virology

Background:

• Recurrent respiratory papillomatosis (RRP) is the most common benign laryngeal neoplasm in children, often causing hoarseness and stridor.
• Caused by human papillomavirus (HPV) types 6 and 11, RRP incidence is estimated at 4.3 per 100,000 children in the US.
• Disease severity correlates with younger age at diagnosis, necessitating frequent surgical interventions.

Purpose of the Study:

• To review the current understanding of RRP, including its causes, symptoms, and diagnostic challenges.
• To explore existing and potential adjuvant therapies for managing RRP.
• To highlight the need for improved treatment strategies and preventative measures.

Main Methods:

• Literature review of RRP, focusing on epidemiology, clinical presentation, and management.
• Analysis of current adjuvant therapies, including dietary supplements, acid reflux control, antivirals, chemotherapy, and photodynamic therapy.
• Discussion of the potential role of HPV vaccination in disease prevention.

Main Results:

• RRP presents with voice changes and stridor, with other symptoms including cough and respiratory distress.
• Differential diagnoses include asthma, croup, allergies, vocal nodules, and bronchitis.
• Adjuvant therapies have shown limited success in curing RRP and may carry significant side effects.

Conclusions:

• Despite being histologically benign, RRP is challenging to control, leading to significant morbidity and mortality.
• Current adjuvant therapies offer limited efficacy and potential risks, underscoring the need for novel treatments.
• The development of a quadrivalent HPV vaccine is being explored as a preventative strategy against RRP.