Abstract
Background: To report the impediments to the diagnosis and management of children with JuvenileOnset Recurrent Respiratory Papillomatosis as seen in a teaching hospital in West Africa. Methods: Retrospectively analysed study of participants requiring surgical intervention for histologically confirmed juvenile onset recurrent respiratory papillomatosis managed at the Department of Otorhinolaryngology, University of Ilorin Teaching Hospital, Ilorin over a 10-year period (2002-2011) using prospectively collated database. Results: Juvenile-Onset Recurrent Respiratory Papillomatosis constituted 8.8% of 307 laryngeal pathologies seen during the study period. 18 (66.7%) were males and 9 (33.3%) females with a sex ratio (M:F) of 2:1. Age ranged from 1 year 4 months to 12 years with a mean age of 6.1 years (SD = 2.78), with the 6 - 10 age group constituting the largest categories in 51.9% of patients seen. Patients from low socioeconomic class constituted slightly over half of the patients studied (51.9%). 55.5% of the patients presented late (>13 months). All patients presented with hoarseness, stridor and difficulty in breathing. Misdiagnosis made by the referring clinician included Asthma, Laryngo-tracheo-bronchitis, Foreign body aspiration and Laryngomalacia. Involvement of the glottis occurred in 70.4% of cases seen, while bilateral involvement was present in 91.3% of cases operated. Recurrence was seen in 63.0% of the patients and the best attendance at follow-up clinic was during the first three months post surgical extirpation. Emergency tracheostomy was done to relieve airway obstruction in 17 (63.0%) patients. Conclusion: Impediments to diagnosis and management of JORRP are multifactorial. Misdiagnosis, late presentation and poor follow-up clinic attendance of patients with JORRP is still a common occurrence among the physicians. Recommendations on how to improve management and outcome of JORRP were made.
Highlights
Juvenile-Onset Recurrent Respiratory Papillomatosis (JORRP) is the most common benign neoplasm of the lanryngeal region amongst children
Juvenile-Onset Recurrent Respiratory Papillomatosis (JORRP) constituted 8.8% of a total 307 laryngeal pathologies seen during the study period at the University of Ilorin Teaching Hospital, Ilorin, Nigeria
The age ranged from 16 months to 12 years with a mean age of 6.1 years (SD = 2.78), with the 6 - 10 age group constituting the largest categories of patients seen, 14 (51.90%), followed by 1 - 5 age group, 12 (44.40%) (Table 1)
Summary
Juvenile-Onset Recurrent Respiratory Papillomatosis (JORRP) is the most common benign neoplasm of the lanryngeal region amongst children. To report the impediments to the diagnosis and management of children with JuvenileOnset Recurrent Respiratory Papillomatosis as seen in a teaching hospital in West Africa. Methods: Retrospectively analysed study of participants requiring surgical intervention for histologically confirmed juvenile onset recurrent respiratory papillomatosis managed at the Department of Otorhinolaryngology, University of Ilorin Teaching Hospital, Ilorin over a 10year period (2002-2011) using prospectively collated database. Results: Juvenile-Onset Recurrent Respiratory Papillomatosis constituted 8.8% of 307 laryngeal pathologies seen during the study period. 55.5% of the patients presented late (>13 months). Recurrence was seen in 63.0% of the patients and the best attendance at follow-up clinic was during the first three months post surgical extirpation.
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