Juvenile laryngeal papillomatosis: From etiology to treatment

Authors: Delia HORHAT*, Raluca HORHAT, Marioara POENARU, S. COTULBEA, Carmen PANAITESCU, N. BALICA, C. SARAU, F. HORHAT, Valeria MOCANU, Adelina JIANU

Affiliation: University of Medicine and Pharmacy “Victor Babeş” Timişoara, Romania

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ABSTRACT. The juvenile laryngeal papillomatosis is the most frequent benign tumour of the larynx. In 1800 Sir Morrel MacKenzie describes papillomas as pharyngo-laryngeal lesions at a child, and the term of juvenile laryngeal papillomatosis has been introduced by Chevalier Jakson in 1940. The etiological agent is HPV types 6 and 11 and the section of the respiratory tract the most frequently infected is the squamocolumelar junction. Juvenile laryngeal papillomatosis is a disease more frequent between 3 and 5 years, characterised by multiple relapses and exuberant growth at the level of the laryngeal mucosa. The annual costs of the treatment of this disease are over 123 million USD. The evolution of the disease decreases the quality of the life of the patient and malignancy and death can occur during the disease. Objectives: bringing new informations about the etiology, the diagnosis and the treatment of the disease for the specialties that deal with this pathology, especially paediatrics and otolaryngologists. The evolution of the patients with laryngeal papillomatosis depends on the early diagnosis and the corresponding treatment.           Material and method: using data from the literature of specialty and the clinical experience in the ENT Clinic in Timisoara we present actualities in the epidemiology, the diagnosis and the treatment in the juvenile laryngeal papillomatosis. Conclusions: juvenile laryngeal papillomatosis is caused by the HPV types 6 and 11. The treatment of this disease isn’t standardised; for this reason it is sometimes different for every patient depending on the formation of the specialist and the technology available in every clinic. The treatment follows two objectives: relapses and the reestablishment of the respiratory and phonatory function.

Keywords: juvenile papillomatosis, HPV, laser CO2, cidofovir, interferon