Treatment of paediatric laryngeal papillomas: web survey of British Association of Paediatric Otolaryngologists

Abstract

Recurrent respiratory papillomatosis is the most common benign neoplasm of the larynx in children. Intralesional injection of cidofovir may have some potential as an adjunctive treatment. There is no standardised protocol in the UK for the management of recurrent respiratory papillomatosis. This study aimed to investigate the management practices of surgeons treating paediatric recurrent respiratory papillomatosis in the UK. A web questionnaire survey was sent by e-mail to all members of the British Association of Paediatric Otorhinolaryngology. Out of 35 respondents, 23 were at that time treating children with recurrent respiratory papillomatosis. Nineteen respondents preferred to use a microdebrider, 12 preferred laser, and 5 preferred cold steel along with either laser or a microdebrider. Twelve surgeons used cidofovir for selected patients and 12 surgeons did not use cidofovir for any patients. Cidofovir was considered after 0–4 surgical procedures by seven respondents, after 4–6 surgical procedures by four respondents and after 6 surgical procedures by six respondents. Eleven respondents warned patients about the possible side effects of cidofovir and five gave no warning. There was no consensus as to when it would be appropriate to use cidofovir, indicating the need for cidofovir usage guidelines.