title: Is recurrent respiratory papillomatosis a manageable or curable disease?
abstract: Recurrent respiratory papillomatosis (RRP) is a relatively rare disease with potentially devastating consequences for the patient. The purpose of this study was to evaluate the patterns of recurrence of RRP after surgery and determine the effectiveness of combined concurrent adjuvant therapy.
  
  
  
  A total of 86 patients were diagnosed with and operated on for RRP. The clinical characteristics of 29 of the 86 patients who had undergone operations at other hospitals and who were followed up for >2 years were evaluated retrospectively. A combined concurrent adjuvant therapy was performed with microlaryngeal surgery, 585-nm pulsed dye laser (PDL) application, and an intralesional cidofovir injection. To evaluate the recurrence pattern, the larynx was divided into 10 subsites, and patients were investigated for the frequency of recurrence at the subsites after the operation.
  
  
  
  Twenty-nine subjects required a mean of 3.0 operations to achieve complete remission for 2 years. The most common subsites for recurrence were the anterior commissure, subglottis, and epiglottis according to increasing number of operations. The subsites of recurrence tended to be closely correlated with the laryngeal submucosal glandular density distribution. A complete en-bloc layer excision, including the submucosal glands, using cold instruments decreased the recurrence rate of RRP. Applying PDL minimized scarring and provided significant posttreatment voice-quality improvement.
  
  
  
  The results of the recurrent pattern analysis suggest that a combined concurrent adjunctive treatment might be promising as a cure for RRP and restoration of vocal function after treatment.
  
  
  
  4. Laryngoscope, 126:1359-1364, 2016.
authors.affiliation: Yeson Voice Center, Institute of Performing Art Medicine, Seoul, South Korea.
authors.forename: Hyung-Tae
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, JSC Medical University, Astana, Kazakhstan.
authors.forename: Aigul Saparadievna
authors.initials: AS
authors.lastname: Baizhumanova
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002648:Child; D000077404:Cidofovir; D003131:Combined Modality Therapy; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000473:pathology / Q000601:surgery; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage; D030361:Papillomavirus Infections / Q000473:pathology / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012074:Remission Induction; D012141:Respiratory Tract Infections / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014832:Voice Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality / Q000528:radiation effects; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir
keywords: Recurrent respiratory papillomatosis; cidofovir; laryngeal papilloma; pulsed dye laser; vocal fold; voice