title: Clinical features, health-related quality of life, and adult voice in juvenile-onset recurrent respiratory papillomatosis.
abstract: OBJECTIVE
  To determine clinical features, health-related quality of life, and adult voice in patients with a history of juvenile-onset recurrent respiratory papillomatosis (JORRP).
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  All 32 patients with JORRP treated at Helsinki University Hospital between 1975 and 1994 were invited to an outpatient visit in spring 2008, and 18 of them (56%) entered the study. Each patient had an age- and gender-matched control subject with similar smoking habits. Videolaryngostroboscopy was performed and voice quality determined by acoustic and perceptual analysis. Voice-quality characteristics of the whole patient group and the recurrence-free patients were examined separately. Subjective voice-related disability was studied with voice handicap index (VHI) and health-related quality of life with a 15D questionnaire.
  
  
  RESULTS
  Acoustic analysis showed that patients had statistically significantly higher values in percent jitter, percent shimmer, and noise-to-harmonics ratio. Perceptual analysis indicated higher scores for patients in overall grade, roughness, breathiness, and strain. Acoustic and perceptual values for recurrence-free patients (n = 14) were also significantly higher than those for their matched paired controls. No statistically significant differences emerged for handicap related to voice or to health-related quality of life. Four study patients (22%) had undergone tracheotomy, indicating severity of juvenile-onset disease.
  
  
  CONCLUSIONS
  JORRP is a risk factor for permanent laryngeal pathology and voice-disturbances in adulthood.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Group Administration, Helsinki, Finland. taru.t.ilmarinen@hus.fi
authors.forename: Taru
authors.initials: T
authors.lastname: Ilmarinen
authors.forename: Heljä
authors.initials: H
authors.lastname: Nissilä
authors.forename: Heikki
authors.initials: H
authors.lastname: Rihkanen
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.forename: Petra
authors.initials: P
authors.lastname: Pietarinen-Runtti
authors.forename: Anne
authors.initials: A
authors.lastname: Pitkäranta
authors.forename: Leena-Maija
authors.initials: LM
authors.lastname: Aaltonen
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010212:Papilloma / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D011788:Quality of Life / Q000523:psychology*; D013018:Sound Spectrography; D013061:Speech Acoustics; D049489:Stroboscopy; D014741:Video Recording; D014832:Voice Disorders / Q000175:diagnosis* / Q000523:psychology*; D055815:Young Adult