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Updated: Jan 27, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Laryngopharyngeal Reflux Is a Potential Risk Factor for Juvenile-Onset Recurrent Respiratory Papillomatosis
Martin Formánek1, Pavel Komínek1, Debora Jančatová1
1Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. Listopadu 1790, 70852 Ostrava, Czech Republic.
Insights
Laryngopharyngeal reflux (LPR) may be a risk factor for juvenile-onset recurrent respiratory papillomatosis (JORRP). This study found LPR in 45.5% of children with JORRP, suggesting it activates latent human papillomavirus (HPV) infections.
Area of Science:
- Otolaryngology
- Pediatric Respiratory Medicine
- Infectious Diseases
Background:
- Juvenile-onset recurrent respiratory papillomatosis (JORRP) is caused by human papillomavirus (HPV), but its low prevalence suggests other contributing factors.
- Laryngopharyngeal reflux (LPR) is a potential risk factor for adult-onset recurrent respiratory papillomatosis.
- This study explored LPR as a potential risk factor for JORRP in children.
Purpose of the Study:
- To investigate the potential role of LPR as a risk factor in the development of JORRP in children.
- To determine the prevalence of LPR in pediatric patients diagnosed with JORRP.
Main Methods:
- A prospective case-series study included 11 children with JORRP requiring microlaryngoscopy.
- Laryngeal biopsies were analyzed using immunohistochemistry to detect HPV and pepsin (indicating LPR).
- Data were collected from November 2015 to November 2017 at a tertiary referral hospital.
Main Results:
- All 11 JORRP patients were infected with HPV (types 6 or 11).
- Pathologic LPR was diagnosed in 5 out of 11 children (45.5%).
- No patients had a history of immunodeficiency or significant environmental exposures like tobacco smoke.
Conclusions:
- LPR may act as a risk factor for JORRP, potentially by activating latent HPV infections.
- These findings align with previous research suggesting LPR's role in adult-onset recurrent respiratory papillomatosis.
- Further investigation into LPR as a JORRP risk factor is warranted.
Introduction:
Human papillomavirus (HPV) causes juvenile-onset recurrent respiratory papillomatosis (JORRP). Although HPV is common in children, the prevalence of JORRP is low. It is likely that other factors contribute to the pathogenesis of JORRP, during either activation or reactivation of a latent HPV infection. There is evidence that laryngopharyngeal reflux (LPR) might be such a risk factor for adult-onset recurrent respiratory papillomatosis. This study investigated if LPR might also be a risk factor for JORRP.
Materials And Methods:
Children with JORRP of the larynx that required microlaryngoscopy at a tertiary referral hospital were included in this prospective case-series study from November 2015 to November 2017. Using immunohistochemistry, HPV infection and pepsin associated with LPR were diagnosed from laryngeal biopsies.
Results:
Eleven children (aged 4-14 years) were analyzed. No patient had a history of immunodeficiency or tobacco smoke exposure. All patients underwent at least three previous surgeries due to JORRP and had been vaccinated against HPV in the past. Five children were treated using antivirotics and immunomodulators. The only known maternal risk factor was that three mothers were primiparous. All 11 samples were infected with HPV (type 6 or 11). Pathologic LPR was diagnosed in 5/11 children (45.5%).
Conclusion:
LPR may be a risk factor for JORRP, contributing to its development by activating or reactivating a latent HPV infection. Results are in accordance with those from our previous study in adults.
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