British Association of Paediatric Otorhinolaryngology members experience with recurrent respiratory papillomatosis.
OBJECTIVE
To establish current practice in the treatment of recurrent respiratory papillomatosis (RRP) in the UK.


METHODS
Consultant members of the British Association of Paediatric Otorhinolaryngology (BAPO) were sent a questionnaire on current practice concerning the management of recurrent respiratory papillomatosis in the paediatric population.


RESULTS
The response rate was 39.4% perhaps reflecting the relatively small number of otolaryngologists who treat this condition. Data were analysed from 41 respondents representing 27 departments for a total of 103 patients. A total of 13 patients (12.6%) received adjuvant medical therapies with the antiviral agent cidofovir accounting for 10 patients. Distal spread of RRP has occurred in 27 (26.2%) patients. There were six reported deaths due to progressive RRP. Various lasers (CO(2), KTP, and pulsed dye) are the preferred method of surgical removal of RRP in children. Spontaneous ventilation (65.3%) is the preferred method of anaesthesia. Half of the consultants do not routinely send for HPV subtyping and 75% send lesions for histological examination if there is a change in growth pattern. Two thirds of respondents do not routinely treat their patients with antireflux medication.


CONCLUSIONS
There is a need for the establishment of a centralized national base to which all treating consultants can report their cases. The time has come for national multicenter controlled trials on the use of adjuvant interventions for the treatment of both severe and less severe RRP disease. Both of the above can be organized under the umbrella of BAPO.
Tasca
Razvan A
RA
Department of ENT, Royal Liverpool Children's Hospital Alder Hey, Eaton Road, Liverpool L12 2AP, United Kingdom. r.tasca@btinternet.com
McCormick
Maxwell
M
Clarke
Ray W
RW
D016588:Anticarcinogenic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D000077404:Cidofovir; D003596:Cytosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016208:Databases, Factual; D019538:Health Care Surveys; D052140:Human papillomavirus 11; D052163:Human papillomavirus 6; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007372:Interferons / Q000627:therapeutic use; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000601:surgery* / Q000821:virology; D053685:Laser Therapy; D009364:Neoplasm Recurrence, Local; D063065:Organophosphonates / Q000627:therapeutic use*; D010036:Otolaryngology; D010212:Papilloma / Q000188:drug therapy* / Q000601:surgery* / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D006113:United Kingdom
D016588:Anticarcinogenic Agents; D000998:Antiviral Agents; D007211:Indoles; D063065:Organophosphonates; D003596:Cytosine; D007372:Interferons; C016517:indole-3-carbinol; D000077404:Cidofovir