Laryngeal distribution of adult-onset recurrent respiratory papillomatosis: A longitudinal study

Laryngoscope. 2019 Sep;129(9):1993-1997. doi: 10.1002/lary.27694. Epub 2019 May 6.

Abstract

Objectives/hypothesis: To describe recurrence patterns in patients with recurrent respiratory papillomatosis (RRP) following surgical intervention.

Study design: Single-center, retrospective, longitudinal case series.

Methods: Initial and follow-up laryngoscopic examinations of seven previously untreated adult-onset RRP patients were reviewed. Patients were followed longitudinally for periods ranging from 3 months to 7 years. Lesion locations were recorded using a twenty-one region laryngeal schematic, and maps were generated to illustrate the distribution of disease before and after cold-knife or potassium-titanyl-phosphate laser intervention. Univariate and multivariate analyses were employed to examine variables affecting recurrence patterns.

Results: Across all patients, a statistically significant correlation between initial distribution and primary recurrence was observed. Seventy-five percent of new lesions were adjacent to regions with preexisting disease; 83% of new glottic lesions were adjacent to preexisting glottic lesions, and 66% of supraglottic lesions were adjacent to preexisting supraglottic regions. No statistically significant differences in recurrence rate were observed across sites.

Conclusions: In previously untreated patients with adult-onset recurrent respiratory papillomatosis, lesions tended to recur either in the same regions or regions adjacent to those affected at the time of initial surgery.

Level of evidence: 4 Laryngoscope, 129:1993-1997, 2019.

Keywords: Recurrent respiratory papillomatosis; human papillomavirus; recurrence; vocal fold; voice.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Female
  • Glottis / pathology*
  • Glottis / surgery
  • Humans
  • Laryngoscopy
  • Larynx / pathology
  • Larynx / surgery
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Papillomavirus Infections / pathology*
  • Papillomavirus Infections / surgery
  • Respiratory Tract Infections / pathology*
  • Respiratory Tract Infections / surgery
  • Retrospective Studies
  • Treatment Outcome

Supplementary concepts

  • Recurrent respiratory papillomatosis