Summary about Disease
Laryngeal papillomatosis (LP), also known as recurrent respiratory papillomatosis (RRP), is a rare condition characterized by the growth of benign tumors (papillomas) in the larynx (voice box), trachea (windpipe), and other parts of the respiratory tract. These papillomas are caused by the human papillomavirus (HPV), most commonly types 6 and 11. RRP can cause significant airway obstruction, voice changes, and breathing difficulties, and often requires repeated surgical removal of the papillomas.
Symptoms
Common symptoms of laryngeal papillomatosis include:
Hoarseness
Weak cry (in infants)
Chronic cough
Stridor (noisy breathing)
Dyspnea (difficulty breathing)
Voice changes (raspy or breathy voice)
Airway obstruction (can be life-threatening)
Swallowing difficulties (dysphagia)
Gasping
Pneumonia
Failure to thrive (in children)
Causes
Laryngeal papillomatosis is caused by infection with the human papillomavirus (HPV), specifically HPV types 6 and 11 in the majority of cases. The virus is usually acquired during childbirth from a mother with genital HPV infection. In adults, it can be contracted through oral-genital contact.
Medicine Used
There is no cure for laryngeal papillomatosis, and treatment primarily focuses on managing the symptoms and removing the papillomas. While not curative, some medications used in conjunction with surgery or for adjunctive therapy include:
Cidofovir: An antiviral medication that can be injected into the papillomas or administered intravenously.
Bevacizumab: An angiogenesis inhibitor that can reduce the growth of papillomas by cutting off their blood supply.
Interferon: An immune modulator that helps the body fight the HPV infection.
Retinoids: Medications derived from Vitamin A, can sometimes be used to help slow papilloma growth. Disclaimer: Consult with a doctor for the right medicine as each person has their own medical history.
Is Communicable
Yes, laryngeal papillomatosis is communicable. It is caused by the human papillomavirus (HPV), which can be transmitted from mother to child during childbirth or through oral-genital contact in adults.
Precautions
Precautions to reduce the risk of contracting or spreading HPV, which causes laryngeal papillomatosis, include:
HPV vaccination: Vaccination against HPV can prevent infection with the types of HPV that most commonly cause laryngeal papillomatosis.
Safe sex practices: Using condoms during sexual activity can reduce the risk of HPV transmission.
Cesarean section: In pregnant women with genital HPV infection, a Cesarean section may be recommended to reduce the risk of transmission to the baby during childbirth.
Avoid oral-genital contact
Avoid sharing personal items
Regular check-ups: Routine medical check-ups can help detect and manage HPV infections early.
How long does an outbreak last?
Laryngeal papillomatosis is a chronic condition. It is not an outbreak but a recurrence of the growth of papillomas. Papillomas can regrow after being removed, leading to repeated need for treatment. There is no set time for how long an outbreak lasts as it depends on individual factors such as immune response, HPV type, and treatment effectiveness. Without treatment, the papillomas will continue to grow, potentially leading to airway obstruction.
How is it diagnosed?
Laryngeal papillomatosis is diagnosed through:
Laryngoscopy: A procedure where a doctor uses a flexible or rigid scope with a light and camera to visualize the larynx and vocal cords.
Biopsy: A small tissue sample is taken from the papillomas and examined under a microscope to confirm the diagnosis.
HPV testing: Testing the tissue sample for the presence of HPV and identifying the specific HPV type.
Imaging studies: In some cases, imaging studies like CT scans or MRIs may be used to assess the extent of the papillomas and rule out other conditions.
Timeline of Symptoms
The timeline of symptoms can vary depending on the age of onset (juvenile vs. adult) and the severity of the disease.
Juvenile-onset RRP: Symptoms often appear in infancy or early childhood, typically within the first few years of life. Initial symptoms may be mild hoarseness or a weak cry, progressing to stridor and breathing difficulties.
Adult-onset RRP: Symptoms may develop more gradually, starting with hoarseness or voice changes that worsen over time. Difficulty breathing may occur as the papillomas grow and obstruct the airway.
Progression: Without treatment, symptoms will worsen. This includes chronic cough, swallowing difficulties, failure to thrive, or recurrent pneumonia.
Important Considerations
Laryngeal papillomatosis is a chronic condition that requires ongoing management.
Multiple surgeries may be needed to remove the papillomas.
The condition can have a significant impact on voice, breathing, and quality of life.
Psychological support and counseling may be beneficial for patients and their families.
Research is ongoing to develop more effective treatments and potentially a cure for laryngeal papillomatosis.
Airway obstruction is a medical emergency. Seek immediate care if having trouble breathing.