Massive oropharyngeal papillomatosis causing obstructive sleep apnea in a child

Obstructive sleep apnea in children is most often secondary to severe adenotonsillar hypertrophy. A 5 1/2-year-old boy presented with loud snoring, increasing dysphagia, nocturnal choking, and apnea. Extensive papillomatosis of the uvula, soft palate, and nasopharynx was found to be causing the obstruction. Although multiple papillomas of the larynx and tracheobronchial tree are well known, the occurrence of extensive papillomas of the oral cavity is rare. The unusual clinical presentation and pathologic significance are discussed.