Vocal cord papilloma: Warts in the Voicebox

Recurrent Respiratory Papillomatosis (RRP) is a rare and chronic medical condition characterized by the growth of benign, wart-like growths (papillomas) in the respiratory tract, primarily in the larynx (voice box), but also in other parts of the respiratory system such as the trachea, bronchi, and lungs. It is caused by the human papillomavirus (HPV), particularly types 6 and 11.

The papillomas can vary in size and location, and they can obstruct the airway, leading to breathing difficulties, hoarseness, and other voice-related problems. The condition is especially concerning in children, as it can interfere with normal breathing and speech development.

RRP is classified into two types:

Juvenile-Onset RRP: This form of RRP is typically diagnosed in children under the age of 5. The papillomas can grow rapidly and frequently, requiring frequent interventions such as surgical removal. These children may require multiple surgeries over their lifetime.

Adult-Onset RRP: This form of RRP is less common and usually diagnosed in adults. The growth of papillomas is generally slower compared to juvenile-onset RRP.

Treatment for RRP involves surgical removal of the papillomas using various techniques such as laser surgery, microdebriders, and other specialized instruments. However, due to the recurring nature of the disease, papillomas often return and require repeated interventions. In some cases, medications like interferon or antiviral drugs may be used to help manage the condition.

HPV vaccination is recommended to reduce the risk of RRP. The HPV vaccine, such as Gardasil, can protect against HPV types 6 and 11, which are the primary causes of RRP.

RRP can be a challenging condition to manage, and a multidisciplinary approach involving ear, nose, and throat (ENT) specialists, speech therapists, and other healthcare professionals is often necessary to provide comprehensive care and support for individuals affected by this condition. Regular follow-up visits and ongoing management are crucial to monitor for recurrence and address any complications that may arise.

Dr Jeeve Kanagalingam

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