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Clinical Research

Long Term Outcome of Juvenile Onset Recurrent Respiratory Papillomatosis in University Kebangsaan Medical Centre

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https://doi.org/10.32448/entupdates.673674
Bee See, G., Mohd Shakri, N., & Loh Chen Nee, J. (2020). Long Term Outcome of Juvenile Onset Recurrent Respiratory Papillomatosis in University Kebangsaan Medical Centre. ENT Updates, 10(1). https://doi.org/10.32448/entupdates.673674
Volume 10 Issue 1 (2020)
Copyright (c) 2021 Goh Bee See, Nadhirah Mohd Shakri, Jenny Loh Chen Nee
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors

  • Goh Bee See
    Department of Otorhinolaryngology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Nadhirah Mohd Shakri Department of Otorhinolaryngology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Jenny Loh Chen Nee Department of Otorhinolaryngology, Pantai Hospital Ayer Keroh, Melaka, Malaysia

Objective: To review the long term outcome of juvenile onset recurrent respiratory papillomatosis (JORRP) in University Kebangsaan Medical Centre (UKMMC).

Methods: A sixteen-year retrospective study – from January 2002 to June 2019 – of patients who presented with JORRP at our hospital was carried out.

Results: Nineteen cases were identified with the youngest age of presentation being eight months old. The mean follow-up time was 4.8 years. All patients had glottic papilloma, ten had multi-site involvement, namely at the subglottic, trachea, oropharynx and one case of distal spread to the lungs. The majority (71.4%) of patients with tracheostomy had extralaryngeal spread and shorter surgical intervals (a mean of 3.2 procedures per year). All our patients were treated surgically. Two patients with aggressive disease received a trial of the adjuvant therapies Gardasil and Cidofovir. However, no improvement was observed.

Conclusion: The worst prognosis is seen in youngeronset JORRP. Surgery is the mainstay of treatment and patients with aggressive disease may need adjuvant therapy. Unfortunately, there is a lack of a standard protocol for adjuvant therapies. Tracheostomy increases the risk of extralaryngeal spread and aggressive disease, and thus should be reserved for patients with severe airway compromise.

Keywords:

Human papillomavirus infection respiratory tract pediatrics tracheostomy