title: Laryngeal sequelae of recurrent respiratory papillomatosis surgery in children.
abstract: OBJECTIVE
  To evaluate laryngeal sequelae from surgical treatment of recurrent respiratory papillomatosis in children, as well as associated risk factors.
  
  
  METHODS
  Case-control study. Medical record data analysis of 50 children with recurrent respiratory papillomatosis, divided into two groups: with and without laryngeal sequelae. The group of patients with laryngeal sequelae was compared to those without sequelae in regard to the onset of disease, age at first surgery, number and frequency of surgeries, disease stage, and type of surgery (CO2 laser, cold forceps).
  
  
  RESULTS
  23 patients (46%) sustained laryngeal sequelae. The most frequent sequela was anterior commissure synechia (17 patients [34%]), followed by glottic stenosis (six patients [12%]). There was no statistically significant difference between groups with and without laryngeal sequelae regarding the disease onset (p = 0.93), age at first surgery (p = 0.68), number of surgeries (p = 0.22), annual frequency of surgery (p = 0.93), presence of papilloma in anterior (p = 0.430) or posterior commissure (p = 0.39), and type of surgery (p = 0.27). The Derkay anatomical score (a staging system that assesses the extent of the disease in the aerodigestive tract) was significantly higher in the laryngeal sequelae group (p = 0.04).
  
  
  CONCLUSIONS
  Laryngeal sequelae are a frequent complication of recurrent respiratory papillomatosis surgical treatment in children, particularly anterior commissure synechiae and glottic stenosis. Advanced stages are associated with increased risk of laryngeal sequelae after surgery.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. juli64@ig.com.br
authors.forename: Juliana Sato
authors.initials: JS
authors.lastname: Hermann
authors.forename: Paulo
authors.initials: P
authors.lastname: Pontes
authors.forename: Luc Louis Maurice
authors.initials: LL
authors.lastname: Weckx
authors.forename: Reginaldo
authors.initials: R
authors.lastname: Fujita
authors.forename: Melissa
authors.initials: M
authors.lastname: Avelino
authors.forename: Shirley Shizue Nagata
authors.initials: SS
authors.lastname: Pignatari
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007829:Laryngostenosis / Q000150:complications*; D007830:Larynx / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D030361:Papillomavirus Infections / Q000150:complications* / Q000601:surgery; D011183:Postoperative Complications; D012141:Respiratory Tract Infections / Q000150:complications* / Q000601:surgery; D012307:Risk Factors