Overview and Facts about Recurrent Respiratory Papillomatosis
Recurrent respiratory papillomatosis (RRP) is a rare condition in which benign (noncancerous) lesions (papillomas) grow in the respiratory tract—the passageway consisting of the nose, mouth, throat, and lungs.
Although lesions can develop anywhere along the respiratory tract, they primarily affect the larynx and the vocal cords. There are two subtypes of RRP: juvenile-onset and adult-onset.
Symptoms and Signs of Recurrent Respiratory Papillomatosis
A persistently hoarse, weak, or strained voice is one of the main symptoms of RRP. The severity of symptoms depends on the size and location of the papillomas. Other symptoms may include:
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Difficulty breathing (dyspnea) or noisy breathing (stridor)
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Chronic coughing
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Difficulty speaking (dysphonia)
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Difficulty swallowing (dysphagia)
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Loss of voice (aphonia)
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The sensation of something stuck in the throat
Symptoms tend to be more severe in children than in adults. Infants who are affected may have a weak cry, episodes of choking and may also fail to gain weight and grow at the expected rate for their age.
Left untreated, papillomas can eventually block the airways, resulting in life-threatening breathing difficulties.
Tests and Diagnosis of Recurrent Respiratory Papillomatosis
RRP is typically diagnosed by a specialist in otolaryngology (ENT) based on symptoms, a detailed patient history, and specialized tests known as an indirect or direct laryngoscopy.
During an indirect laryngoscopy, a flexible fiberoptic camera is inserted through the nose and into the throat to view the larynx.
A direct laryngoscopy is performed under general anesthesia and allows the vocal folds and other parts of the larynx to be viewed under high magnification.
Causes and Risk Factors of Recurrent Respiratory Papillomatosis
RRP in adults is caused by specific types of the human papillomavirus (HPV). This common virus is passed through genital contact, most often during sex.
Most people exposed to HPV, however, do not develop a related illness. In children, the virus is believed to be passed from mother to child during pregnancy or childbirth as the child passes through the birth canal.
Treatment and Care for Recurrent Respiratory Papillomatosis
Surgery is the primary method for removing papillomas. As the name suggests, once lesions are removed, they often recur. It is common for some patients to have multiple surgeries.
The recurrence of these lesions, however, is unpredictable; some may require surgery a few times a year, while others only need it a few times throughout their life.
Papillomas are typically removed using laser procedures or microdebridement—a procedure that uses a rapidly rotating blade to remove the growth.
Growing evidence suggests that certain medications may effectively slow the regrowth of papillomas and increase the time between surgeries.
