Recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis lesions of the respiratory tract affect both children and adults. The etiology currently accepted by researchers is the human papillomavirus. Though relatively rare in children, these lesions can be serious and potentially fatal if the airway should become compromised or obstructed. Of the numerous treatments tested since recurrent respiratory papillomatosis was first described, the surgical laser is the most effective tool for controlling these lesions. A 5-year-old female patient who suffered from recurrent respiratory papillomatosis since the age of 2 and had over 80 laser treatments in a 3-year period is discussed. Laser and interferon administered concurrently lessened the frequency of laser therapy in this patient. Variations in number and size of recurrent respiratory papillomatosis lesions present a challenge to the anesthetist. Delivery of anesthesia requires precise preanesthetic planning and coordination. Since these lesions are most prevalent in the laryngeal airway, the surgical field must be shared by the anesthetist and the surgeon. The etiology, medical and physical therapeutic management, anesthetic management, and complications of patients with RRP are presented.