[Juvenile laryngeal papillomatosis--immunisation with the polyvalent vaccine gardasil]

Juvenile laryngeal papillomatosis is a rare condition caused by human papilloma virus (HPV). In cases with rapid recurrences permanent impairments of voice and breathing are almost inevitable due to the frequent need of debulking surgeries. Efforts to lower the recurrence rate comprise the adjuvant use of interferon alpha, local cidofovir, photodynamic therapy or mumps vaccination. In the present case we tried to positively influence the aggressive course of disease in a two year old boy by immunisation with the quadrivalent HPV vaccine Gardasil(R). Chromogenic in-situ hybridisation analysis and polymerase chain reaction (PCR) of lesion tissue showed simultaneous infection with the HPV-Types 6 and 11. After the third immunisation the disease became stable. No further surgery was necessary for the last ten months. The risk profile of this adjuvant treatment is low. We think it worth to initiate a multicentre trial to prove a benefit of this treatment even if no complete virus elimination can be achieved.