A Retrospective Study of Recurrent Respiratory Papillomatosis in WestBengal, India
Journal Title: Saudi Journal of Medical and Pharmaceutical Sciences - Year 2018, Vol 4, Issue 5
Abstract
Abstract:Recurrent respiratorypapillomatosis is a rare benign disease of the upper airway caused by HPV, primarily affecting the paediatric age group. A retrospective analysis of 11 cases of recurrent respiratorypapillomatosiswas done in the present study extending for 30 years in three Medical Colleges of India. The presenting age of the patients was 2 to 7 years. Around 73% of recurrent respiratory papillomatosis cases had been diagnosed within 5 years of age. In our study, we did not find any case of adult onset recurrent respiratory papillomatosis and all the cases were of juvenile onset. Both males and females were affected equally with a male to female ratio of 1.2: 1. The incidence was more in the population with lower socio-economic conditions.Out of the total 11 cases, 6 patients required emergency tracheostomy for obstruction of the airway due to extensive involvement of the larynx. Microlaryngoscopic removal of the lesions with microdebrider was the primary treatment combined with adjuvant nonsurgical/medical treatments to contain the virus and growth of the tumours. In the case of the 5 (45%) patients presenting with hoarseness of voice without respiratory distress, complete microlaryngoscopic excision of the lesions were possible. However there were recurrences in 3of these 5 cases, requiring further surgeries. In the case of the 6 (55%) patients, who required emergency tracheostomy for acute respiratory distress, complete microlaryngoscopic excision of the lesions were not possible in the first surgery, due to extensive pathology and there were recurrences in all these cases. Collectively, there were recurrences in 9 cases out of the total 11 cases. The recurrences occurred within 3 to 6 months and required 4 revision surgeries on an average. The incidence of recurrent respiratory papillomatosis has decreased gradually in the recent past due to improvement of hygiene and medical care. We did not find any case of RRP in the last 10 years. The quadrivalent HPV vaccine (GARDASIL) is effective in decreasing the prevalence of recurrent respiratory papillomatosis. There issparsity of data of recurrent respiratory papillomatosis in the Indian subcontinent and it is suggested that sufficient epidemiological data should be accumulated to characterize the disease, as in Western countries. Keywords: RRP, recurrent respiratory papillomatosis, HPV, human papilloma virus, quadrivalent vaccine.
Authors and Affiliations
Saileswar Goswami, Shivaam Kesarwaani, Dipankar Kumar Basumata, Subrata Kumar Das, Dev X, MaragathamKubendiran Nandhini
Keywords
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