OR Management of Recurrent Respiratory Papilloma

Abstract

Surgical management of recurrent respiratory papillomatosis has depended upon surgical removal and debulking of disease to maintain a patent airway and preserve vocal function. Over time, this has evolved from cold instrumentation alone to microscope-guided laser ablation. Powered instrumentation in the form of microdebriders has also come to serve an important role for the rapid removal of exophytic, airway obstructive disease. With this evolving technologic sophistication, the surgical paradigm has progressed from maintaining a patent airway to maintaining vocal function. This chapter will discuss the evolution of surgical management, the considerations for airway management and operative anesthesia, and will finally discuss current adjuvant medical therapies and imaging modalities that seek to limit disease recurrence and enhance detection and surgical management.