Recurrent respiratory papillomatosis associated with gastroesophageal reflux disease in children

Borkowski, G.; Sommer, P.; Stark, Th.; Sudhoff, Holger; Luckhaupt, H.

doi:10.1007/s004050050166

Cited by 58 publications

(43 citation statements)

References 18 publications

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“…Other antiviral drugs (e.g., acyclovir and valacyclovir), and indole-3-carbinol were also used in small series [1,2,16,[19][20][21][22]. According to a limited number of studies, the effective management of laryngopharyngeal reflux may also result in an improved control of RRP [12,23].…”

Section: Introductionmentioning

confidence: 99%

Human papilloma virus vaccination in patients with an aggressive course of recurrent respiratory papillomatosis

Boltežar

Matičič

Šereg-Bahar

et al. 2014

Eur Arch Otorhinolaryngol

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In the case of an aggressive course of recurrent respiratory papillomatosis (RRP), adjuvant therapy can be used besides surgery. The aim of the study was to investigate the influence of vaccination with a quadrivalent vaccine against human papilloma viruses (HPV) types 6, 11, 16 and 18 on the course of RRP. Eleven subjects aged 13-46 years with a rapid growth of laryngeal papillomas were included in the study. They were vaccinated with three doses of the quadrivalent prophylactic HPV vaccine (Silgard(®), MSD) and followed up for 12-52 months. The intervals between the successive surgical procedures, the extension of the disease (Derkay score) at each surgery, and the number of surgical procedures per year before vaccination and after its completion were compared. The mean interval between the surgical procedures was 271.2 days before the vaccination and 537.4 days after it (p = 0.034). The mean number of surgeries per year was 2.16 before the vaccination and 0.93 after it (p = 0.022). The Derkay score did not change significantly after vaccination. Complete remission of the disease was observed in one patient, partial response to the vaccination was observed in seven patients and no response was observed in three patients. In conclusion, vaccination with the quadrivalent HPV vaccine can favorably influence the course of RRP in patients with the rapid growth of the papillomas. It significantly prolongs the intervals between the surgical procedures and reduces the number of procedures needed in the majority of patients. The present investigation can serve as a pilot study for further research. For a final conclusion a longer follow-up and studies on more patients are necessary.

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Section: Introductionmentioning

confidence: 99%

Human papilloma virus vaccination in patients with an aggressive course of recurrent respiratory papillomatosis

Boltežar

Matičič

Šereg-Bahar

et al. 2014

Eur Arch Otorhinolaryngol

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“…5) Risk factors leading to virus activation in RRP have not been recognized; however, gastroesophageal reflux disease has been suggested as a possible factor. 10) Malignant degeneration into squamous cell carcinoma occurs in 3% to 5% of papilloma patients and more often in patients with a history of smoking or radiation therapy. However, other risk factor for malignant transformation has been noted.…”

Section: Discussionmentioning

confidence: 99%

A Case of Multiple Squamous Cell Papillomas of the Trachea

Ogata-Suetsugu

Izumi

Takayama

et al. 2011

ATCS

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We report a case of 68-year-old woman suffering from breathlessness on exertion with stridor. A chest computed tomography showed a tumor arising from the posterior wall of the trachea. The diagnosis was squamous cell papilloma of the surgically removed tumor, which had caused the asphyxiation. After removal of the tumor, the patient received radical therapy: semiconductor laser transpiration. Polymerase chain reaction (PCR) detected human papilloma virus (HPV) type 6, thought to be the cause of the respiratory papilloma.Key words: papilloma, human papilloma virus, polymerase chain reaction, semiconductor laser, trachea Case ReportA 68-year-old woman was admitted to our hospital because of breathlessness with stridor, which gradually worsened over the previous 2 months. She was a nonsmoker and had no history of radiotherapy to the trachea. Physical examinations were normal, except for inspiratory and expiratory stridor. Her routine laboratory results were normal. Pulmonary function test revealed a severe obstructive impairment: a forced vital capacity (FVC) of 3.09 L (135.5% of predicted), a forced expiratory volume in 1 s (FEV1.0) of 0.91 L (53.2% of predicted), and FEV1.0 to FVC ratio of 29.5%. Flow volume loop pattern showed intrathoracic upper airway obstruction. Chest computed tomography (CT) and flexible bronchoscopy documented a cauliflower-like, warty tumor. The main tumor size was 15 × 10 × 10 mm and was located 30 mm below the vocal cords ( Fig. 1a and 1b). In addition, we observed two other small polypoid lesions. We started an emergency tracheostomy of the patient under local anesthesia to remove the tumors and secure her airway.During the tracheostomy, she became nearly asphyxiated. Then, we administered general anesthesia. After completing the tracheostomy, we successfully removed the main tumor without preparing an extracorporeal cardiopulmonary bypass. Histologically, the tumor specimen contained squamous cell papilloma with mild, atypical koilocytes; thus, the diagnosis was multiple respiratory papillomas ( Fig. 1c and 1d). Polymerase chain reaction (PCR) amplification (Fig. 2) detected human papilloma virus (HPV) type 6 DNA in the tumor specimen. Otherwise, there was no viral DNA in normal tissue. After removal of the primary tumor, we used semiconductor laser transpiration, a radical therapy, to remove the remaining tumors. The patient got relief from her symptoms with no recurrence 8 months after treatment. DiscussionRespiratory papilloma has been reported in children and adults. Onset during adulthood is more common among men and often occurs in the third or fourth Ann

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“…22 Other authors have found a potential relation between the severity of RLP and gastroesophageal reflux. 8,11 Furthermore, recent papers have shown that most of the surgical complications of RLP patients, such as scars, laryngeal membranes, and airway stenosis are late complications and tend to be more significant and frequent in patients with gastroesophageal reflux. 22 Based on our study, we believe that the treatment of reflux may be a further treatment strategy to control this high morbidity disease.…”

Section: Discussionmentioning

confidence: 99%

“…7 Borkowski et al in 1999 first suggested a correlation between RLP and gastroesophageal reflux by showing that controlling reflux resulted in reduced growth of laryngeal papillomas. 8 At the same time other authors started to note that gastroesophageal reflux was very frequent in RLP patients, and that this condition could also be associated with other laryngeal disorders such as recurrent croup, subglottal stenosis and vocal nodules. 9,10 The HPV virus in RLP causes recurrence, and may remain latent in the laryngeal mucosa for an unknown time.…”

Section: Introductionmentioning

confidence: 99%

Refluxo gastroesofágico em pacientes portadores de papilomatose recorrente de laringe

Pignatari

Liriano

Avelino

et al. 2007

Rev. Bras. Otorrinolaringol.

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Evi dence of a relation between gastroesophaeal reflux and pediatric respiratory disorders increases every year. Many respiratory symptoms and clinical conditions such as stridor, chronic cough, and recurrent pneumonia and bronchitis appear to be related to gastroesophageal reflux. Some studies have also suggested that gastroesophageal reflux may be associated with recurrent laryngeal papillomatosis, contributing to its recurrence and severity. Aim: the aim of this study was to verify the frequency and intensity of gastroesophageal reflux in children with recurrent laryngeal papillomatosis. Material and Methods: ten children of both genders, aged between 3 and 12 years, presenting laryngeal papillomatosis, were included in this study. The children underwent 24-hour double-probe pH-metry. Results: fifty percent of the patients had evidence of gastroesophageal reflux at the distal sphincter; 90% presented reflux at the proximal sphincter. Conclusion: the frequency of proximal gastroesophageal reflux is significantly increased in patients with recurrent laryngeal papillomatosis.

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Recurrent respiratory papillomatosis associated with gastroesophageal reflux disease in children

Cited by 58 publications

References 18 publications

Human papilloma virus vaccination in patients with an aggressive course of recurrent respiratory papillomatosis

Human papilloma virus vaccination in patients with an aggressive course of recurrent respiratory papillomatosis

A Case of Multiple Squamous Cell Papillomas of the Trachea

Refluxo gastroesofágico em pacientes portadores de papilomatose recorrente de laringe

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