Pediatric laryngeal papillomatosis: A review

Abstract

Laryngeal papillomatosis in pediatric age is an uncommon disease caused by the human papillomavirus which presents as warty, exophytic growths in the larynx. Child suffering from laryngeal papillomatosis frequently present with hoarseness of voice. In aggressive form laryngeal papillomatosis, it can lead to severe airway obstruction. Papillomas in the larynx often appear as exophytic nodules and this disease unpredictable in nature with spontaneous regression to aggressive persistent or recurrent disease. Fiberoptic laryngoscopy is helpful for identification of the lesions, whereas helical computed tomography is highly accurate for identification and of the disease and assessing the laryngeal airway. The definitive diagnosis is made by biopsy with histopathological examination. Surgical excision is the treatment of choice using microdebrider, CO2, or potassium titanylphosphate laser and coblation or cold steel instruments. The surgical complications may lead to vocal fold scarring, granulation tissue, webbing, and laryngeal stenosis. Coblation and Microdebrider are safe and cost effective than laser and coblation. Only maternal risk factor was primparous. Children with laryngeal papillomatosis associated with multiple surgeries in the past due to recurrence and aggressive nature of the diseases. Very young child and patients with tracheostomy need strict follow-up in case of sever diseases. In this review article, we disczuss the epidemiology, etiopathology, clinical presentations, diagnosis, and current treatment options of pediatric laryngeal papillomatosis.