What Is Recurrent Respiratory Papillomatosis?

J.M. Willhite

Recurrent respiratory papillomatosis (RRP) is a serious medical condition initiated by exposure to the human papilloma virus (HPV). This potentially deadly condition may affect anyone of any age and is defined by marked tumor development in the throat and respiratory system. In the absence of a cure, treatment is centered on tumor removal and easing one’s symptoms. It is a preventable condition and individuals are encouraged to take precautionary measures, from practicing safe sex to receiving the HPV vaccine.

The respiratory and abdominal organs.
The respiratory and abdominal organs.

Exposure to human papilloma virus subtypes 6 and 11 is linked directly to the onset of recurrent respiratory papillomatosis. In the presence of ongoing research, there are no established guidelines to evaluate why some people get RRP and others do not. Related to veneral warts, HPV-6 and -11 can be passed from mother to child during a vaginal delivery. Pregnant women who know they have active HPV infection, as demonstrated by the presence of venereal warts, are encouraged to take steps to prevent passing the infection on to their baby, such as considering a Cesarean delivery.

Recurrent Respiratory Papillomatosis requires frequent monitoring by a physician.
Recurrent Respiratory Papillomatosis requires frequent monitoring by a physician.

The presence of HPV in the larynx initiates abnormal cell development that results in the formation of lesions that mature into nodules, or polyps. A diagnosis of recurrent respiratory papillomatosis is generally made by the administration of a laryngoscopy. The procedure involves introducing a narrow tube, outfitted with a camera, into the throat or nasal cavity so a clear view of the larynx and vocal cords may be obtained. If polyps are discovered, the individual is admitted to the hospital so a biopsy may be performed. A general anesthetic is administered to facilitate the collection of tissue samples.

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Individuals with RRP experience pronounced, progressive changes to their voice. Frequently, hoarseness will present, giving way to a change in pitch that causes one to strain to speak. As existing polyps mature and new ones form on the larynx, the airway becomes obstructed making it difficult to breathe. Advanced recurrent respiratory papillomatosis can initiate tumor development extending beyond the larynx to affect the bronchial tubes and lungs.

There is no cure for this condition. Treatment involves proactive monitoring of the throat and respiratory tract for new or aggressive growths. Considering HPV is often a precursor to malignancy, especially oropharyngeal cancers as found in individuals with active HPV infection, it is essential to closely monitor the condition of someone with RRP. As tumors mature, they must be surgically removed to prevent further complication.

In addition to periodic surgery to remove tumors, individuals with recurrent respiratory papillomatosis are usually placed on a regimen of antiviral medications to slow the disease's progression. Intralesional drug therapy, such as the use of a steroidal-based medication, is also used to reduce inflammation and slow lesion development. In some cases, dietary changes may also be recommended to help boost immunity and possibly slow disease progression.

Reccurent respiratory papillomatosis may lead to tumors in the respiratory system.
Reccurent respiratory papillomatosis may lead to tumors in the respiratory system.

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