What is recurrent respiratory papillomatosis?

Recurrent respiratory papillomatosis is a disease marked by recurrent multiple growths of benign tumors, or papillomas, in the respiratory tract. The wart-like growths can be found in the nose, pharynx (throat), larynx (voice box), trachea (windpipe), esophagus (swallowing tube) and rarely in the lungs. The disease is caused by two strains (six and 11) of the common human papilloma virus (HPV). Most of the cases manifest themselves in early childhood. Papillomas can start to grow and occlude the airway and impair breathing. The disease is usually progressive, with worsening symptoms if left untreated, but it can wax and wane unpredictably. The papillomas tend to grow on the vocal cords, the trachea and the bronchi. Children with papillomatosis are often treated for asthma before the correct diagnosis is made.

Even though papillomas are benign tumors, they can become cancerous in rare cases.

Symptoms

• Hoarseness
• Difficulty breathing
• Stridor (noisy breathing)

Diagnosis

• Physical exam
• Laryngoscopy and bronchoscopy — examination of the throat, larynx, vocal cords and the bronchi with a scope

Treatment

The goal of the treatment is to clear the airway of growths and to prevent or reduce the occurrence of new ones.

• Surgery to remove the growths
• Antiviral medications to try to suppress the replication of the virus

When to Call for Help

Call your pediatrician if your child develops any of the symptoms listed above.