Respiratory papillomatosis
| Laryngeal papillomatosis | |
|---|---|
| Classification and external resources | |
| Specialty | otolaryngology |
| ICD-10 | D14.1 |
| ICD-9-CM | 212.1 |
Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis or glottal papillomatosis or associated with condyloma acuminata, is a rare medical condition (2 per 100,000 adults and 4.5 per 100,000 children), caused by a human papillomavirus (HPV) infection of the throat. Laryngeal papillomatosis causes assorted tumors or papillomas to develop over a period of time. Without treatment it is potentially fatal as uncontrolled growths could obstruct the airway. Laryngeal papillomatosis is caused by HPV types 6 and 11, in which benign tumors form on the larynx or other areas of the respiratory tract. These tumors can recur frequently, may require repetitive surgery, and may interfere with breathing. The disease can be treated with surgery and antivirals. In addition antiangiogenic therapy shows promising results.
In general, physicians are not sure what causes certain people to develop laryngeal papillomatosis while others who have been exposed to HPV types 6 and 11 do not develop the disease. Since the disease is most commonly found in children, the disease may be caused by an infant contracting HPV from the mother during vaginal child birth. There is no evidence that it is transmitted through oral sex, and it is not considered a sexually transmitted disease.
In adults, the symptoms of laryngeal papillomatosis are hoarseness, or a strained or breathy voice. Size and placement of the tumors dictate the change in the person's voice. Breathing difficulties may occur but more commonly are found in children.
In babies and small children, the signs and symptoms include a weak cry, trouble swallowing, noisy breathing, and chronic cough. Noisy breathing may be a stridor, which can sound like a whistle or a snore, and is a sign that the laryngeal or tracheal parts of the airway are narrowing.
A physician may diagnose laryngeal papillomatosis by placing a mirror into a patient's mouth to reflect light onto the vocal cords and examining the larynx. More often, a doctor or a trained speech-language pathologist diagnoses laryngeal papillomatosis by an indirect laryngoscopy in the office. This procedure involves the placement of a flexible, fiber optic camera through the patient's nose to view the vocal folds in the throat or the use of a straight, rigid camera placed through the mouth to view the vocal folds.
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