Intralesional Cidofovir application in recurrent laryngeal papillomatosis.
Recurrent laryngeal papillomatosis is a benign disease of the larynx often leading to organic and functional restrictions. The therapeutic treatment of choice in larynx-obstructing papillomatosis is at present surgical laser ablation. The effectiveness of adjuvant intralesional injection of the virustaticum Cidofovir has been investigated recently in a variety of therapeutic models. The present case study deals with the treatment of recurrent laryngeal papillomatosis by means of surgical laser ablation of the laryngeal papillomas with adjuvant local injection of the virustaticum Cidofovir (dose of 5 mg/1 ml). Within the period from October 2001 to August 2004, ten patients aged between 5- and 70 years were treated with intralesional injections of Cidofovir. Papillomatosis was confirmed histologically in all cases, and the virus types were defined in part. Each of the patients underwent clinical-phoniatric examinations and was photographed for documentation. After 2-7 treatments with surgical laser papilloma ablation and intralesional Cidofovir injections, all patients showed a definite papilloma reduction, while in six cases complete remission was achieved. During the follow-up period of 8-30 months, not a single recurrence of the laryngeal papillomatosis occurred. In the majority of patients, a clear improvement in the voice was achieved. There were no local or systemic side effects caused by the virustaticum. Intralesional injection of Cidofovir is an adjuvant, but not a curative therapeutic option in recurrent laryngeal papillomatosis. Remission of previously frequently recurrent laryngeal papillomas can be achieved, but recurrence after longer treatment-free intervals is also possible.
Pudszuhn
Annett
A
ENT Department, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Magdeburger Str. 12, 06097, Halle/Saale, Germany. kerstin.neumann@medizin.uni-halle.de
Welzel
Cornelia
C
Bloching
Marc
M
Neumann
Kerstin
K
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D000077404:Cidofovir; D003131:Combined Modality Therapy; D003596:Cytosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D052140:Human papillomavirus 11 / Q000302:isolation & purification; D052163:Human papillomavirus 6 / Q000302:isolation & purification; D006801:Humans; D007820:Laryngeal Mucosa / Q000473:pathology / Q000821:virology; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D063065:Organophosphonates / Q000627:therapeutic use*; D010212:Papilloma / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D012074:Remission Induction
D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir