Laryngeal papillomatosis: Difference between revisions
No edit summary |
No edit summary |
||
| Line 9: | Line 9: | ||
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing. | Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing. | ||
{{SK}} Recurrent respiratory papillomatosis; glottal papillomatosis | |||
==Overview== | ==Overview== | ||
'''Laryngeal papillomatosis''', also known as recurrent respiratory papillomatosis, is a [[Rare disease|rare medical condition]], caused by an [[Human papillomavirus|HPV]] infection of the throat. It causes assorted [[tumor]]s, [[papilloma]]s, to develop over a period of time. Without treatment it is potentially fatal as uncontrolled growths could obstruct the [[airway]]. | '''Laryngeal papillomatosis''', also known as recurrent respiratory papillomatosis, is a [[Rare disease|rare medical condition]] (2 per 100,000 adults and 4.5 per 100,000 children)<ref name="NIDCD">">{{cite web |title=National Institute of Deafness and other Communication Disorders|location= http://www.nidcd.nih.gov/health/voice/laryngeal.asp|accessdate=2009-09-19}}</ref>{{rp|411}}, caused by an [[Human papillomavirus|HPV]] infection of the throat. It causes assorted [[tumor]]s, [[papilloma]]s, to develop over a period of time. Without treatment it is potentially fatal as uncontrolled growths could obstruct the [[airway]]. Laryngeal papillomatosis is caused by HPV types 6 and 11, in which benign tumors form on the larynx or other areas of the respiratory tract. These tumors can recur frequently, may require repetitive surgery, and may interfere with breathing. The disease can be treated with surgery and antivirals. | ||
==Transmission== | |||
In general, doctors are not sure what causes some people to contract laryngeal papillomatosis while others who have been exposed to HPV types 6 and 11 do not contract the disease. Since the disease is most commonly found in children the disease may be caused by an infant contracting HPV from the mother during vaginal child birth <ref name="Voice Problems">">{{cite web |title=VoiceProblems.org |location= http://www.voiceproblem.org/disorders/rrp/symptoms.asp|accessdate=2009-09-19}}</ref>{{rp|411}}. There is no evidence that it is transmitted through oral sex, and it is not considered a [[sexually transmitted disease]].<ref name="McClay">">{{cite web |author=McClay MD,John E (10/29/08).|title=Recurrent Respiratory Papillomatosis|location= http://www.voiceproblem.org/disorders/rrp/symptoms.asp|accessdate=2009-09-22}}</ref> | |||
==Symptoms== | |||
===Adults=== | |||
In adults the symptoms Laryngeal papillomatosis are hoarseness, or a strained or breathy voice. Size and placement of the tumors dictate the change in the person's voice. Breathing difficulties may occur but more commonly are found in children.<ref name="Voice Problems" /> | |||
===Children=== | |||
In babies and small children the symptoms include a weak cry, trouble swallowing, noisy breathing, and chronic cough. Noisy breathing may be a [[stridor]], which can sound like a whistle or a snore, and is a sign that the laryngeal or tracheal parts of the airway are narrowing.<ref name="Voice Problems" /> | |||
==Diagnosis== | |||
A doctor may diagnose laryngeal papillomatosis by placing a mirror into a patient's mouth to reflect light onto the vocal cords and examining the larynx. More often, a doctor or a trained speech-language pathologist diagnoses laryngeal papillomatosis by an indirect laryngoscopy in the office. This procedure involves the placement of a flexible, fiber optic camera through the patient's nose to view the vocal folds in the throat or the use of a straight, rigid camera placed through the mouth to view the vocal folds.<ref name="RRPF">">{{cite web |title=Recurrent Respiraory Papillomatosis Foundation|location= http://www.nidcd.nih.gov/health/voice/laryngeal.asp|accessdate=2009-09-26}}</ref> | |||
The most accurate way to diagnose laryngeal papillomatosis is for a [[biopsy]] to be conducted and for the lesion to be tested for HPV. This procedure takes place in an operating room with the patient under general anesthesia. This is sometimes the best option for small children. This disease is most often misdiagnosed as [[asthma]], [[croup]], or [[chronic bronchitis]].<ref name="McClay" /> The consequences may be serious, as papillomas are at least partially obstructing the airway to cause these symptoms and should be removed immediately.<ref name="RRPF" /> | |||
== Treatment == | == Treatment == | ||
Traditional [[surgery]] and [[carbon dioxide laser]] surgery, a "no touch" removal of affected tissue, are forms of treatment for laryngeal papillomatosis. Carbon dioxide laser removal is the most common removal method.<ref name="McClay" /> The carbon dioxide laser must be used precisely to prevent scarring, [[fibrosis]], and [[laryngeal web malformation]]. In children, carbon dioxide laser is effective for removing papillomas on the larynx. | |||
[[Photodynamic therapy]] controls [[tumor]]s by using targeted dyes and bright light to illuminate tumors.<ref name="NIDCD" /> In this procedure, a doctor injects a light sensitive dye that is only absorbed by the tumors. Then the doctor activates the dye using a bright light, and the tumors are eliminated. This procedure has also been able to decrease the number of tumors that reoccur.<ref name="NIDCD" /> | |||
Another method is [[tracheotomy]], which reroutes air around the affected area. An incision is made in the front of the patient's neck, and a [[Tracheal tube|breathing tube]] is inserted through a hole (stoma) into the windpipe. The patient is then able to breathe through the tube. Although this is usually temporary, some patients must use the tube indefinitely.<ref name="NIDCD" /> This method should be avoided if at all possible, since insertion of a breathing tube may cause the tumors to form as far down as the lungs.<ref name="McClay" /> | |||
Many [[Antiviral drug]]s like Cidofovir have been used to treat laryngeal papillomatosis, but none completely stops the tumors from growing. Most antivirals are injected to control the frequency of tumor growth. The efficacy of the same is debated and subject to research. Some side effects of antivirals include dizziness, headaches, and body aches. | |||
Regardless of the treatment used, the tumors will reoccur. In severe cases, tumors may occur once or twice a month. In less severe cases, tumors may occur once or twice a year. | |||
[[Category:Rare diseases]] | [[Category:Rare diseases]] | ||
Revision as of 14:08, 26 November 2012
Template:DiseaseDisorder infobox
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Synonyms and keywords: Recurrent respiratory papillomatosis; glottal papillomatosis
Overview
Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis, is a rare medical condition (2 per 100,000 adults and 4.5 per 100,000 children)[1]:411, caused by an HPV infection of the throat. It causes assorted tumors, papillomas, to develop over a period of time. Without treatment it is potentially fatal as uncontrolled growths could obstruct the airway. Laryngeal papillomatosis is caused by HPV types 6 and 11, in which benign tumors form on the larynx or other areas of the respiratory tract. These tumors can recur frequently, may require repetitive surgery, and may interfere with breathing. The disease can be treated with surgery and antivirals.
Transmission
In general, doctors are not sure what causes some people to contract laryngeal papillomatosis while others who have been exposed to HPV types 6 and 11 do not contract the disease. Since the disease is most commonly found in children the disease may be caused by an infant contracting HPV from the mother during vaginal child birth [2]:411. There is no evidence that it is transmitted through oral sex, and it is not considered a sexually transmitted disease.[3]
Symptoms
Adults
In adults the symptoms Laryngeal papillomatosis are hoarseness, or a strained or breathy voice. Size and placement of the tumors dictate the change in the person's voice. Breathing difficulties may occur but more commonly are found in children.[2]
Children
In babies and small children the symptoms include a weak cry, trouble swallowing, noisy breathing, and chronic cough. Noisy breathing may be a stridor, which can sound like a whistle or a snore, and is a sign that the laryngeal or tracheal parts of the airway are narrowing.[2]
Diagnosis
A doctor may diagnose laryngeal papillomatosis by placing a mirror into a patient's mouth to reflect light onto the vocal cords and examining the larynx. More often, a doctor or a trained speech-language pathologist diagnoses laryngeal papillomatosis by an indirect laryngoscopy in the office. This procedure involves the placement of a flexible, fiber optic camera through the patient's nose to view the vocal folds in the throat or the use of a straight, rigid camera placed through the mouth to view the vocal folds.[4]
The most accurate way to diagnose laryngeal papillomatosis is for a biopsy to be conducted and for the lesion to be tested for HPV. This procedure takes place in an operating room with the patient under general anesthesia. This is sometimes the best option for small children. This disease is most often misdiagnosed as asthma, croup, or chronic bronchitis.[3] The consequences may be serious, as papillomas are at least partially obstructing the airway to cause these symptoms and should be removed immediately.[4]
Treatment
Traditional surgery and carbon dioxide laser surgery, a "no touch" removal of affected tissue, are forms of treatment for laryngeal papillomatosis. Carbon dioxide laser removal is the most common removal method.[3] The carbon dioxide laser must be used precisely to prevent scarring, fibrosis, and laryngeal web malformation. In children, carbon dioxide laser is effective for removing papillomas on the larynx. Photodynamic therapy controls tumors by using targeted dyes and bright light to illuminate tumors.[1] In this procedure, a doctor injects a light sensitive dye that is only absorbed by the tumors. Then the doctor activates the dye using a bright light, and the tumors are eliminated. This procedure has also been able to decrease the number of tumors that reoccur.[1] Another method is tracheotomy, which reroutes air around the affected area. An incision is made in the front of the patient's neck, and a breathing tube is inserted through a hole (stoma) into the windpipe. The patient is then able to breathe through the tube. Although this is usually temporary, some patients must use the tube indefinitely.[1] This method should be avoided if at all possible, since insertion of a breathing tube may cause the tumors to form as far down as the lungs.[3] Many Antiviral drugs like Cidofovir have been used to treat laryngeal papillomatosis, but none completely stops the tumors from growing. Most antivirals are injected to control the frequency of tumor growth. The efficacy of the same is debated and subject to research. Some side effects of antivirals include dizziness, headaches, and body aches. Regardless of the treatment used, the tumors will reoccur. In severe cases, tumors may occur once or twice a month. In less severe cases, tumors may occur once or twice a year.
- ↑ 1.0 1.1 1.2 1.3 ">"National Institute of Deafness and other Communication Disorders". http://www.nidcd.nih.gov/health/voice/laryngeal.asp. Missing or empty
|url=(help);|access-date=requires|url=(help) - ↑ 2.0 2.1 2.2 ">"VoiceProblems.org". http://www.voiceproblem.org/disorders/rrp/symptoms.asp. Missing or empty
|url=(help);|access-date=requires|url=(help) - ↑ 3.0 3.1 3.2 3.3 ">McClay MD,John E (10/29/08). "Recurrent Respiratory Papillomatosis". http://www.voiceproblem.org/disorders/rrp/symptoms.asp. Missing or empty
|url=(help);|access-date=requires|url=(help) - ↑ 4.0 4.1 ">"Recurrent Respiraory Papillomatosis Foundation". http://www.nidcd.nih.gov/health/voice/laryngeal.asp. Missing or empty
|url=(help);|access-date=requires|url=(help)