[A Case of Juvenile-Onset Laryngeal Papillomatosis Requiring Emergency Airway Management].
Juvenile-onset laryngeal papillomatosis has a serious tendency for rapid growth and repeated recurrence. Thus, patience and prudence are required for the successful management of this pathology. We report herein on 2-year and 4-month-old boy with juvenile-onset laryngeal papillomatosis, which caused remarkable airway constriction that required urgent airway management. He was delivered vaginally by a mother with condyloma acuminatum. Hoarseness appeared at 1 year of age, and retractive breathing was observed at 1 year and 6 months of age. He finally presented with severe wheezing and was admitted to the emergency room of our hospital with a laryngeal tumor strongly resembling a papilloma. Emergency endotracheal intubation was possible by means of a fine endotracheal tube with an internal diameter of 2.5 mm. His supraglottic space was filled with the tumor; thus, making the visibility of the vocal folds difficult. The tumor was surgically removed using a microdebrider under general anesthesia. The histopathological diagnosis was benign papilloma and HPV11 virus was detected. The rapidly growing papilloma showed a strong tendency for recurrence, and four additional surgical procedures had to be performed within 6 months after the first operation. This patient will therefore require cautious medical care in the future.
Yoshihiro
Y
Akazawa
Aibi
A
Akashi
Masatoshi
M
Akutsu
Koushi
K
Mikami
Masahiko
M
Fukasawa
Shigeru
S
Kasugai
Miki
M
Sakamoto
Izumi
I
Koizuka
D058109:Airway Management; D000768:Anesthesia, General; D002675:Child, Preschool; D004632:Emergency Medical Services; D052140:Human papillomavirus 11; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D010212:Papilloma / Q000473:pathology / Q000601:surgery*; D012008:Recurrence