Recurrent respiratory papillomatosis (RRP), also known as papilloma or laryngeal papilloma, is a condition caused by a relatively common virus, the human papilloma virus (HPV).
An infection with HPV causes lumpy growths to form on the vocal cords. These growths are not cancerous but, in their extreme form, can cause some difficulty with breathing. Typically, the growths are small and cause a mild or moderate dysphonia (hoarseness).
A distinguishing aspect of this disease is the tendency for the papilloma to recur after surgical procedures to remove them.
Recurrent Respiratory Papillomatosis Symptoms
The most common symptom of RRP is a voice that is persistently hoarse, weak, low in pitch, breathy or strained. Often dysphonia can occur as well.
Recurrent Respiratory Papillomatosis Diagnosis
RRP is typically diagnosed by an ear, nose and throat doctor performing an examination of the larynx. Most of the time, an ENT doctor or a speech-language pathologist performs a laryngoscopy or a videostroboscopy to make the diagnosis.
Recurrent Respiratory Papillomatosis Treatment
While there is no current cure for patients with RRP, there are several treatment strategies that effectively control this disease.
The mainstay of therapy for RRP involves using a laser to remove the wart-like growths. If the number of growths is small, or if most of it has been removed already in the operating room, we are able to use either the C02 laser or the pulsed-KTP laser in the clinic. We use our transnasal telescope after the administration of topical anesthesia only. This has the advantage of being speedy, safe, well tolerated, and avoids general anesthesia.
Cidofovir is an antiviral medication that was not designed specifically for the human papilloma virus, but there is good evidence supporting its use in some cases of RRP. This medication tends not to cure the papilloma, but rather extends the time between future treatments.
Because these lesions tend to recur (thus the name), it can be frustrating for the patient. As our strategies for managing this condition become less invasive, the disruption to our patient's life is minimized.