Laryngeal papillomatosis in children: The impact of late recognition over evolution

To assess the impact of the delay in recognition of the initial symptoms of laryngeal papillomatosis in children over the evolution of the disease. Retrospective study of patients with respiratory papillomatosis referred from general pediatric practices to a tertiary hospital with pediatric laryngology specialization. Gender, age at time of diagnosis, symptom duration, sites affected at the time of diagnosis, treatment, and evolution of the disease over time were evaluated. From January 2003 to December 2013, 21 patients (15 females and 6 males) were identified and followed for at least 3 years. The average age at which symptoms first appeared was 40.2 months, and the average age at the time of initial treatment was 76 months. The most frequent clinical manifestation was hoarseness. The most common site of involvement was the glottis followed by the supraglottis and subglottis, respectively. Three of the 21 patients required tracheostomy. The average time from symptom onset to diagnosis was 52.3 months. There were no fatalities. On average 3.7 procedures were performed per patient. Patients presenting more than 1 year from the symptom onset to the time of first treatment required a greater number of procedures to control disease. Delay in diagnosis can have negative clinical consequences due to disease progression. The later the diagnosis the more surgeries are needed to control the disease. Involvement of the subglottic larynx is a risk factor for emergent tracheostomy.