Recurrent Respiratory Papillomatosis

Recurrent respiratory papillomatosis (RRP) is a disease that affects the vocal cords and larynx (voice box). Those who are affected by RRP may have issues with their voice, breathing, or swallowing. RRP, caused by the human papillomavirus (HPV), results in the production of wart-like growths (papillomas). These growths may develop in the throat, causing voice changes and difficulty breathing. Surgical intervention is necessary for the removal of the growths followed by medication management to prevent their reoccurrence.

Associated Signs and Symptoms of RRP

Most commonly, a change in voice is associated with this disease as the growths grow directly on the vocal cord. This may result in a raspy or irregular voice. In addition, symptoms may also present as:

  • Chronic coughing
  • Difficulty swallowing
  • Shortness of breath
  • Trouble breathing while asleep

Diagnosing RRP Signs and Symptoms

Initially, a thorough examination of the throat and vocal cords is performed to help determine the causation of voice hoarseness. To better view the vocal cords, additional non-invasive testing may be performed. A laryngoscopy is a short procedure in which a small camera is passed via the nose or mouth to the vocal cords for viewing. To further enhance the analysis of the vocal cords and surrounding anatomy, stroboscopy may be used. This procedur involves the use of specialized light which is timed to the vocal cord’s vibrations.

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Treatment and Management of RRP

RRP is, unfortunately, a disease in which due to its nature, has no definitive “cure.” Typically, surgical treatment is necessary to remove the growth (papilloma). Depending on the severity of the disease and the surgeon’s preference, a traditional or minimally invasive surgical approach may be used.

If performed traditionally, the removal of the growth would be performed through the mouth of an appropriately sedated patient. Once the growth is located via the use of a camera, lasers, and related instruments are then used for removal.

Due to advancements in medicine, a less invasive approach is becoming increasingly common.

Similar to the traditional approach, a camera is also used during a minimally invasive procedure. However, the camera is introduced via the nose to view the growth and patients remain completely awake. Once located, lasers are utilized to remove the growth in a manner that does not disturb the vocal cord’s sensitive tissues.If the minimally invasive surgical approach is performed, the procedure has a shorter recovery time as no general anesthesia is required and can be completed in less than half an hour.

This disease is referenced as recurring as, after initial surgical treatment, the growths tend to return. The plan of care for follow-up and management of this disease may involve the use of certain medications in an effort to minimize the risk of returning growths.

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Managing recurrent respiratory papillomatosis may be difficult as breakouts can occur periodically without any clear reasoning. Although the returning growths commonly develop around the vocal cords and larynx, other locations such as the nose, trachea, and lungs are sometimes affected by RRP.