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Recurrent Respiratory Papillomatosis

(Laryngeal Papillomas)

By

Udayan K. Shah

, MD, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision Sep 2020
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GET THE QUICK FACTS

Recurrent respiratory papillomatosis is caused by human papillomavirus. This tumor is most often diagnosed when it occurs in the voice box as laryngeal papillomas. Although laryngeal papillomas can occur at any age, they most commonly affect children aged 1 to 4 years.

Symptoms

Papillomas are suspected when parents notice hoarseness, a weak cry, or other changes in the child’s voice. Papillomas reappear often and occasionally spread into the windpipe Throat The throat (pharynx) is located behind the mouth, below the nasal cavity, and above the hollow tube that leads from the throat to the stomach (esophagus) and windpipe (trachea) (see figure A... read more (trachea) and lungs, blocking the airway. Rarely, they become cancerous (malignant).

Diagnosis

  • Biopsy

Laryngeal papillomas are detected using a laryngoscope to view the voice box. Doctors remove a piece of the papilloma for examination (biopsy) to confirm the diagnosis.

Treatment

  • Surgical removal

Although some tumors may begin to disappear at puberty, treatment of recurrent respiratory papillomatosis is recommended. Surgical removal is the usual treatment. Many children require numerous procedures throughout childhood to remove the tumors as they reappear.

Other treatments (such as pulsed-dye laser therapy or photodynamic therapy—see Using Lasers to Treat Skin Problems Using Lasers to Treat Skin Problems Port-wine stains are flat pink, red, or purplish discolorations present at birth due to malformed blood vessels. (See also Overview of Skin Growths and Overview of Growths and Malformations... read more Using Lasers to Treat Skin Problems ) as well as an antiviral drug (cidofovir) or a drug that is used to treat cancer (bevacizumab) may be given to children who have a severe case.

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An important part of normal development is an infant’s growing attachment to its parents. As this bond strengthens, the infant may express fear or anxiety when the parents leave. This “separation anxiety” typically begins at around 8 months of age and resolves at around 24 months of age. Which of the following is the normal and expected infant behavior in reaction to a parent leaving the room during the time period of separation anxiety?
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