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Laryngeal papillomatosis
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Laryngeal papillomatosis

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Contributors: Paul C. Bryson MD
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Synopsis

Laryngeal papillomatosis (LP, recurrent respiratory papillomatosis) is a rare type of respiratory papillomatosis that presents with small, wart-like, noncancerous epithelial tumors of the laryngeal mucosa. These papillomas vary in size and growth rates. Recurrence is the rule. LP has juvenile-onset and adult-onset forms. Childhood cases typically develop before age 12 and are more aggressive, as these cases are more likely to recur and require surgical treatment given the smaller pediatric airways. Although aggressive cases are less common in adults than in children, they can still occur.

LP is caused by human papillomavirus (HPV) strains 6 and 11. HPV is spread through sexual contact or when a mother with HPV genital warts passes it onto her baby via childbirth.

Clinical signs and symptoms depend on the patient and the severity of LP. LP most commonly causes a hoarse voice that may be low-pitched or sound strained. Patients may have labored breathing due to airway obstruction. Some patients may have difficulty speaking or may be unable to speak. Infants may have a weak cry, failure to thrive, and episodes of choking. Other clinical symptoms include chronic cough, difficulty swallowing, dyspnea, foreign body sensation, and choking episodes.

In some cases, the disease may go away on its own without requiring treatment or it may only require a few surgical procedures during a patient's lifetime. Complications may occur if left untreated, as airway may be compromised in life-threatening acute respiratory distress. Very rarely, LP may spread to the lungs and patients may experience recurrent pneumonia, chronic lung disease, and, in severe cases, progressive pulmonary failure. More rarely, papillomas become cancerous and develop into squamous cell carcinoma.

There is currently no cure for LP. Treatment usually involves removal of papillomas, reducing the spread of the disease, preventing airway obstruction, and if necessary, improving voice quality. Treatment procedures and interventions vary depending on specific location and size of papillomas, frequency of recurrence, and other factors. Treatment usually requires a multidisciplinary team to create a comprehensive plan individualized to the patient. A number of adjuvant therapies have been tried, all with varying success.

Codes

ICD10CM:
D14.1 – Benign neoplasm of larynx

SNOMEDCT:
232457008 – Laryngeal Papillomatosis

Differential Diagnosis & Pitfalls

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Last Updated: 05/10/2016
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Laryngeal papillomatosis
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Laryngeal papillomatosis : Choking, Cough, Hoarseness, Globus sensation, Dyspnea, Wheezing, Stridor
Copyright © 2019 VisualDx®. All rights reserved.