Respiratory Papillomatosis
Recurrent respiratory papillomatosis (RRP) is a chronic viral disease, caused by human papillomavirus (HPV). It causes wart-like tumors to grow within the upper respiratory tract including larynx and vocal cords. Currently, there is no cure for this disease and even if resected aggressively, it may grow back after months or years.
Symptoms
Papillomatosis can remain asymptomatic for quite some time, however, they grow on the vocal folds they become manifest much earlier. Typical symptoms include:
- Hoarseness
- Noisy breathing
- Shortness of breath
Treatment
Laryngeal papillomatosis is a recurrent disease and patients may have to undergo multiple surgeries throughout their lifetime. If not performed carefully, repeated surgeries to remove papilloma may lead to vocal cord scarring over time with permanent hoarseness. It is therefore crucial to consider not only treatment choices but also surveillance exams to detect early regrowth. Dr. Weidenbecher uses high-definition endoscopes with state-of-the-art diagnostic features (Narrow Band Imaging) to identify papilloma before it even causes symptoms. That way, any necessary intervention to remove papilloma has minimal impact on patients.
Dr. Weidenbecher is a vocal cord specialist who understands how delicate vocal cords are and how to preserve their structure during surgery. Multiple treatment options are available to remove laryngeal papilloma. Dr. Weidenbecher uses a KTP laser which is highly effective against papilloma. This new laser technique reduces damage to the normal layered structure of the vocal fold and preserves the normal voice. Recurring papilloma can be treated safely with the KTP laser again. For frequently recurring laryngeal papilloma, bevacizumab (Avastin) can be injected into the vocal cord to block laryngeal papilloma growth on a molecular level.
The vast majority of RRP treatments can be done in the office and patients are usually able to go back to work the same or next day (see Office based procedures).
Papilloma is growing along both vocal cords (arrow pointing to papilloma). The vocal cord edge is irregular, which results in a hoarse voice.
A specialized light technology called narrow-band imaging (NBI) can be used to detect papilloma more easily. Papilloma has abnormal blood vessels which look like a "strawberry".
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