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Diagnostic challenges of laryngeal papillomatosis and its implications among children in developing country
Ayotunde James Fasunla1, Olawale Akeem Lasisi
1Department of Otorhinolaryngology, University College Hospital, Queen Elizabeth Road, PMB 5116, Ibadan, Oyo State, Nigeria. ayofasunla@yahoo.com
Insights
Laryngeal papillomatosis in children is often misdiagnosed, leading to delayed treatment and complications like tracheostomy. Early recognition by clinicians is crucial for better outcomes.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Respiratory Diseases
Background:
- Laryngeal papillomatosis presents a diagnostic challenge in pediatric patients.
- Mismanagement can lead to significant morbidity.
Purpose of the Study:
- To raise awareness of laryngeal papillomatosis in children.
- To highlight the consequences of its mismanagement.
- To suggest diagnostic approaches.
Main Methods:
- Retrospective review of medical records.
- Inclusion of pediatric patients with histologically confirmed laryngeal papillomatosis.
- Data collected from 1993-2007 at University College Hospital Ibadan.
Main Results:
- 38 pediatric cases identified (60.53% male).
- Only 5.26% were correctly diagnosed initially.
- Diagnosis delays ranged from 5 weeks to 3 months.
- 90% required emergency tracheostomy; 92% underwent surgical excision.
Conclusions:
- Misdiagnosis and mismanagement are prevalent due to lack of clinician familiarity.
- Laryngeal papillomatosis should be a key differential diagnosis for pediatric laryngeal symptoms.
- Early Otorhinolaryngologist involvement is essential for improved clinical outcomes.
Objectives:
To create an awareness of laryngeal papillomatosis in children and the implications of its mismanagement among the general practitioner and paediatricians, and to offer suggestions on its diagnostic techniques.
Method:
Medical records of children with histologically confirmed laryngeal papillomatosis managed at the Otorhinolaryngology department of University College Hospital Ibadan Nigeria through 1993-2007 were reviewed for essential clinical data.
Results:
There were 38 paediatric patients, 23 (60.53%) males and 15 (39.47%) females, with laryngeal papillomatosis. Only 2 (5.26%) of these patients were correctly diagnosed by the referring clinicians. Diagnosis was delayed for 5 weeks to 3 months. About 90% of these patients had emergency tracheostomy and 92% had surgical excision for 2 sections or less.
Conclusion:
Laryngeal papillomatosis misdiagnosis and mismanagement were common in our environment due to clinicians not being conversant with the disease entity. It should therefore be considered an important differential diagnosis in children with laryngeal symptoms to improve its clinical outcome. Otorhinolaryngologists should always be involved early without delay in the management.
