ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Recurrent Respiratory Papillomatosis: Much Has Been Done, but a Long Road Lies Ahead

by Nancy M. Bauman, MD • October 1, 2006

  • Tweet
  • Email
Print-Friendly Version

Recurrent respiratory papillomatosis (RRP) remains a devastating disease for pediatric patients. Each time we diagnose a new case of RRP we are reminded of our limitations in battling a disease that has no known cure, that has an unpredictable course, and that carries a risk of morbidity. Answering probing questions from family members about disease transmission requires sensitivity, as the knowledge that it is a vertically transmitted disease often evokes much guilt in parents.

You Might Also Like

  • Pediatric Recurrent Respiratory Papillomatosis: Fighting the Battle of a Rare But Serious Disease
  • Promise for Recurrent Respiratory Papillomatosis: Pediatric otolaryngologists have high hopes for the HPV vaccine
  • Recurrent Respiratory Papillomatosis: Researchers Advancing Toward Prevention
  • Adjuvant Therapies May Increase Time Between Surgeries for Recurrent Respiratory Papillomatosis
Explore This Issue
October 2006

The lack of a cure for this disease cannot be attributed to lack of research efforts. An infectious etiology for RRP was first proven in 1923 when Ullman injected homogenized papillomata from a child’s larynx into his own forearm and developed papillomatous lesions at the site three months later. Clearly, Dr. Ullman was operating prior to the creation of Institutional Review Boards! Numerous investigators have since sought to find a cure for this virally transmitted disease. Countless treatment modalities have been proposed based on promising preliminary results, only to find that the purported benefit was more likely a reflection of disease variability than efficacy of the drug. I recall the wisdom of Professor Bruce Benjamin, who told me during my fellowship that cures for RRP come and go like passing trends. His wisdom has prevailed.

Vaccines: A Great Leap Forward

The FDA approval of Gardasil in June of this year is the most exciting news for otolaryngologists who treat patients with RRP. This quadrivalent vaccine combines empty virus-like particles with the L1 major capsid protein of HPV-6, -11, -16, and 18 to induce a robust host-antibody response. The Phase II and Phase III trials have demonstrated remarkable safety and efficacy in preventing HPV-related cervical dysplasia and carcinoima in situ from the viral subtypes of interest. While the impetus for creating the vaccine has been to prevent anogenital HPV-related disease, the potential for preventing RRP, which is often considered an orphan disease, is clearly our windfall.

The cost of $360 for the three vaccines that are administered over a six-month period is trivial compared with the anticipated reduction in health care costs allocated to manage HPV-related disease. More than $100 million is spent annually to treat patients with RRP in the United States. This amount is small in comparison to the $1 billion allocated to treat HPV cervical dysplasia, cervical carcinoma, and anogenital warts. Americans unable to afford vaccine therapy can receive it through the Vaccines for Children Program, sponsored by the Centers for Disease Control and Prevention (CDC), or through an adult patient assistance program offered by Merck. The Bill and Melinda Gates Foundation announced in June its plan to give $27.7 million to fund research on how best to introduce the new vaccine to third world countries where HPV causes 25% of all cancers in women.

Use of the vaccine will not obviate the need for PAP smears, as other HPV viral subtypes not covered by the vaccine can still cause premalignant and malignant changes in the cervix.

Pages: 1 2 3 | Single Page

Filed Under: Departments, Head and Neck, Medical Education, Pediatric, Practice Focus Tagged With: pediatrics, prevention, research, respiratory papillomatosis, treatment, vaccineIssue: October 2006

You Might Also Like:

  • Pediatric Recurrent Respiratory Papillomatosis: Fighting the Battle of a Rare But Serious Disease
  • Promise for Recurrent Respiratory Papillomatosis: Pediatric otolaryngologists have high hopes for the HPV vaccine
  • Recurrent Respiratory Papillomatosis: Researchers Advancing Toward Prevention
  • Adjuvant Therapies May Increase Time Between Surgeries for Recurrent Respiratory Papillomatosis

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Non-Acidic Reflux Explains Lack of Response to H2 Blockers and PPIs
    • How 3D Printing Is Transforming the Pediatric Otolaryngology Field
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why Virtual Grand Rounds May Be Here to Stay
    • Otolaryngologist Leverages His Love of Pinball into Second Business
    • These New Imaging Advances May Help to Protect Parathyroids
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Which Otologic Procedures Poses the Greatest Risk of Aerosol Generation?

Polls

Have you used 3D-printed materials in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.