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Recurrent respiratory papillomatosis: an overview of current thinking and treatment.

Abstract
Human papillomaviruses (HPV) infection in benign laryngeal papillomas is well established. The vast majority of recurrent respiratory papillomatosis lesions are due to HPV types 6 and 11. Human papillomaviruses are small non-enveloped viruses (>8 kb), that replicate within the nuclei of infected host cells. Infected host basal cell keratinocytes and papillomas arise from the disordered proliferation of these differentiating keratinocytes. Surgical debulking of papillomas is currently the treatment of choice; newer surgical approaches utilizing microdebriders are replacing laser ablation. Surgery aims to secure an adequate airway and improve and maintain an acceptable quality of voice. Adjuvant treatments currently used include cidofovir, indole-3-carbinol, ribavirin, mumps vaccine, and photodynamic therapy. The recent licensing of prophylactic HPV vaccines is a most interesting development. The low incidence of RRP does pose significant problems in recruitment of sufficient numbers to show statistical significance. Large multi-centre collaborative clinical trials are therefore required. Even so, sufficient clinical follow-up data would take several years.
AuthorsPeter Goon, Chris Sonnex, Piyush Jani, Margaret Stanley, Holger Sudhoff
JournalEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 265 Issue 2 Pg. 147-51 (Feb 2008) ISSN: 0937-4477 [Print] Germany
PMID18046565 (Publication Type: Journal Article, Review)
Topics
  • Human papillomavirus 11 (isolation & purification)
  • Human papillomavirus 6 (isolation & purification)
  • Humans
  • Laryngeal Neoplasms (pathology, surgery, virology)
  • Laser Therapy (methods)
  • Otorhinolaryngologic Surgical Procedures (methods)
  • Papilloma (pathology, surgery, virology)
  • Recurrence

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