Laryngeal papillomatosis

Synonyms

3

Overview

Laryngeal papillomatosis is a form of recurrent respiratory papillomatosis where tumors (papillomas) grow in the larynx (voice box). These tumors can recur frequently, may require repetitive surgery, and may interfere with breathing. The disease can be treated with surgery and antivirals.

Symptoms

Symptoms usually begin with hoarseness and/or a change in the voice. Some people may experience difficulty breathing (dyspnea) and/or experience other life-threatening complications if the papillomas block the airway. The tumors may vary in size and grow very quickly. They often grow back even when removed.

Adults:
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.

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.

Symptoms:

• Breathing difficulty
• Respiratory obstruction
• Swallowing difficulty
• Hoarseness
• Chronic coughing
• Dysphagia
• Voice changes
• Rapid breathing

Causes

Laryngeal papillomatosis is caused by two types of human papilloma virus (HPV), called HPV 6 and HPV 11.

Diagnosis

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.

The most accurate way to diagnose laryngeal papillomatosis is for a biopsy to be conducted and for the lesion to be tested for HPV. This procedure takes place in an operating room with the patient under general anesthesia. This is sometimes the best option for small children. This disease is most often misdiagnosed as asthma, croup, or chronic bronchitis. The consequences may be serious, as papillomas are at least partially obstructing the airway to cause these symptoms and should be removed immediately.

Resources

• NIH