Recurrent Respiratory Papillomatosis

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Recurrent Respiratory Papillomatosis (RRP), also known as Laryngeal Papillomatosis, is a disease of the vocal cords and the airway caused by the Human Papilloma Virus (HPV).
RRP can occur in both adults and children. It consists of benign (non-cancerous) growths that develop in the airway passages, most commonly on and around the vocal cords. These growths are known as papillomas, which is where the condition gets its name.
In general, HPV infections are extremely common–the vast majority of people are exposed to multiple strains of the virus within the first few years of life. However, for unknown reasons, only a small percentage of people who get an HPV infection go on to develop RRP. The most common mode of transmission is through to be through sexual contact or through transmission from mother to baby during birth.

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What Are the Symptoms of RRP?

The most common symptom of RRP is hoarseness, which is caused by the growths on the vocal cords interfering with normal function of the vocal cords. In more severe cases, the disease can spread to the lungs or trachea, and can obstruct the airway, causing difficulty breathing. RRP is best diagnosed by a laryngologist (voice doctor) performing high resolution videostroboscopy of the vocal cords.

What Are the Treatment Options for RRP?

The main treatment for RRP involves surgical removal of the papillomas. This can be done in a variety of ways, depending on the size and location of the papillomas. The main risk of this procedure is scarring of the vocal cords, which is more likely to occur with larger papillomas, more extensive involvement of the surface of the vocal cords, or with an increased number of procedures. Sometimes, medications and certain antibody therapies can be used in conjunction with surgery to help control more severe cases of RRP. The best treatment is PREVENTION: vaccination with the HPV vaccine before exposure to HPV may help prevent the development of RRP down the line. The role of the HPV vaccine is less clear in people who already have RRP, but there are some early studies that suggest that getting the HPV vaccine may help your immune system fight RRP better and slow down the progression of the disease.

Long-term Treatment For RRP

As the name implies, RRP has a tendency to come back even after effective medical and surgical treatment. In fact, most people with this condition will require more than one procedure. Some people can expect to eventually clear up after a few treatments, but others may require regular “clean-up” or maintenance procedures.

Finding the Right Specialist

If you suffer from RRP, it’s important to have a voice specialist at your side who has the right expertise to help ensure the best voice outcomes from your procedures. As a fellowship-trained laryngologist, Dr. Rafii has expertise in performing minimally invasive laser removal of papillomas conveniently in the office without the need for general anesthesia using the latest available technology, and has extensive experience in using voice preserving techniques to get you the best possible outcomes.