ENTtoday
  • Home
  • 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
    • 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
  • Multimedia
    • Video
    • Audio
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
    • eNewsletters
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Suspect Adult Respiratory Papillomatosis with Recurrent Hoarseness after Surgery

by Paula Moyer • July 1, 2006

  • Tweet
  • Email
Print-Friendly Version

Although most respiratory papillomatosis starts in childhood, some patients develop symptoms in adulthood. While adult-onset disease is milder, patients often still require multiple surgeries to be free of the characteristic lesions and the associated hoarseness.

You might also like:

  • Recurrent Respiratory Papillomatosis: Researchers Advancing Toward Prevention
  • Adult-Onset Recurrent Respiratory Papillomatosis May Be Associated with Number of Sexual Partners
  • Pediatric Recurrent Respiratory Papillomatosis: Fighting the Battle of a Rare But Serious Disease
  • Recurrent Respiratory Papillomatosis: Much Has Been Done, but a Long Road Lies Ahead
Explore this issue:
July 2006

In a joint phone interview, two leading experts in respiratory papillomatosis discussed the diagnosis and management of adult patients. Blake Simpson, MD, is Associate Professor and Deputy Chair of the Otolaryngology–Head and Neck Center at the University of Texas Health Science Center in San Antonio. Clark A. Rosen, MD, is Associate Professor of Otolaryngology at the University of Pittsburgh School of Medicine (Pa.), where he is the Director of the Voice Center.

“Adult respiratory papillomatosis is going to be a much less aggressive course than what otolaryngologists are used to seeing with children,” said Dr. Simpson. “These lesions grow slower, and patients go longer intervals between surgeries. Adult patients do better than children.”

Although the route of transmission is known to be perinatal in children, the transmission of adult-onset disease is unknown, he added. “My theory is that people with adult onset were probably were born with it,” he said. “It lives in the tissue of their larynx and with aging, the immune surveillance system isn’t as vigilant, and the papilloma starts growing.” He noted that this development can happen at any age. “I’ve seen it surface in 70-year-olds.”

People with adult-onset disease, then, may have had a perinatal transmission that has been dormant throughout their lives. “When you take the papilloma lesion off along with some normal adjacent tissue, you’ll find the virus in both the affected and the apparently healthy tissue,” Dr. Simpson said. “I think this phenomenon explains why the condition is milder in adults: they may have been living with it all their lives. There are a couple of theories about how adults get it, but perinatal transmission and subsequent dormancy is the only one that makes sense regarding how adults get the disease.”

Although the route of transmission is known to be perinatal in children, the transmission of adult-onset disease is unknown.

Figure. In the patient with papillomatosis, the view on the fiberoptic scope will show multiple lesions with grapelike projections on the vocal cords.

click for large version
Figure. In the patient with papillomatosis, the view on the fiberoptic scope will show multiple lesions with grapelike projections on the vocal cords.

What to Look For

Patients with adult respiratory papillomatosis typically have little unique in their presentation, Dr. Simpson said. “If a 20- to 60-year-old patient says he or she has been hoarse for the past several years, there could be many causes,” he said. “They typically have gradually progressive hoarseness.” Again, this report alone would not lead down the papillomatosis pathway. “However, if the patient says, ‘I’ve had two surgeries with polyps removed,’ papillomatosis may be the cause. The whole differentiating thing about papilloma is that it recurs. If it recurs, it’s almost always papilloma.”

Pages: 1 2 3 4 Single Page

Filed Under: Departments, Laryngology, Medical Education, Practice Focus Tagged With: adult-onset, diagnosis, Dysphonia, medication, outcomes, respiratory papillomatosis, surgery, treatment, vocal cordsIssue: July 2006

You might also like:

  • Recurrent Respiratory Papillomatosis: Researchers Advancing Toward Prevention
  • Adult-Onset Recurrent Respiratory Papillomatosis May Be Associated with Number of Sexual Partners
  • Pediatric Recurrent Respiratory Papillomatosis: Fighting the Battle of a Rare But Serious Disease
  • Recurrent Respiratory Papillomatosis: Much Has Been Done, but a Long Road Lies Ahead

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

  • How Writing Helps a Medical Resident Better Care for Patients
  • How Physicians Can Build a Network to Boost Their Career
  • How To Survive the First Year of Medical Residency
  • ACGME Revises Cap on Resident Work Hours
  • Ethical Implications of Burnout in Otolaryngology Residents
  • Popular this Week
  • Most Popular
  • Most Recent
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Is There a Crisis in the Otolaryngology Match?
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Weaning Patients Off of PPIs
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Vertigo in the Elderly: What Does It Mean?
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Short-and Long-Term Data Suggest Efficacy of Turbinate Ablation
    • Counseling Patients on Safe Nasal Irrigation
    • Artificial Intelligence and Machine Learning in Otolaryngology
    • Letter from the Editor: Peer Reviewing Sensational Headlines
    • Is Topical Epinephrine Safe for Hemostasis in Endoscopic Sinus Surgery?
    • Is it Safe to Kiss in Era of HPV Head and Neck Cancer ‘Epidemic’?

Polls

Is artificial intelligence an advantage for medicine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy

Visit: The Triological Society • The Laryngoscope • Triological Meeting Posters

Wiley
© 2019 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.