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Recurrent Respiratory Papillomatosis or glottal papillomatosis, is a rare disorder caused by the human papilloma virus (HPV), RRP produces wart-like growths. Benign tumors primarily affect the vocal cords and larynx (voice box), it is a disease that can cause voice, breathing, and swallowing concerns. If it finds its way in the throat, these growths may cause voice changes and breathing problems. The tumors may lead to narrowing of your airways, which cause vocal changes or airway obstruction. Surgery is the common papillomatosis treatment to remove the growths and may include medication to help prevent them from returning.
Signs and Symptoms of RRP
The most common symptom associated with RRP is voice changes. Papilloma, a benign epithelial tumor, grows directly on the vocal cord, which causes a hoarse and irregular voice. Some symptoms include:
- Shortness of breath
- Trouble in breathing while asleep
- Chronic coughing
- Swallowing difficulties
Diagnosis of RRP
Finding the source of hoarseness starts with a thorough examination of the throat and vocal cords. Laryngoscopy is a quick procedure where a small camera is maneuvered through the mouth or nose to locate the vocal cords. Stroboscopy uses specialized light illuminating on the vocal cords, it flashes light lasting a fraction of a second that further analyzes anatomy by “freezing” the movement of the vocal cords.
The appearance of multiple or rarely, single, white growths with a lumpy texture are papillomas that has been described as similar to cauliflower. Papillomas are usually present in the larynx, especially on the vocal folds and in the space above the vocal folds called the ventricles. They can spread to other parts of the larynx as well and throughout the aerodigestive tract which is from the mouth to the lower respiratory tract. It is more common for children for papillomas to spread to regions beyond the larynx than adults.
Treatment for RRP
Unfortunately, there is no way to fully treat RRP due to the nature of the condition. Papillomatosis treatment usually involves surgery to remove the growth, or papilloma. Removal can be routinely performed through the mouth while the patient is sedated. The surgeon proceeds to use a camera to locate the growth, which was then removed with lasers and related instruments.
An increasingly common alternative is a minimally invasive procedure while the patient is completely awake, it still accomplishes the same result. A camera placed inside the nose is used to view the papilloma while the procedure is performed. The papilloma is removed with the use of lasers, done in a way that leaves sensitive vocal cord tissues alone. Unlike the traditional procedure, the minimally invasive technique does not require general anesthesia, finished in just half an hour, and has a faster recovery time.
Since growths often return even after initial surgery the condition is commonly referred to as being recurrent. Some follow-up treatments in the form of medication after surgery is given to minimize the risk of the growths returning.
Periodic breakouts of recurrent respiratory papillomatosis may occur randomly and without any apparent reason, this makes it difficult to manage the condition. While the resulting growths mostly happen around the larynx and vocal cords, it also sometimes occur in other locations such as nose, trachea, and lungs.