A Clinical Analysis of Recurrent Respiratory Papillomatosis and Detection of Human Papilloma Virus Using Polymerase Chain Reaction

Kong, Soo Keun; Wang, Soo Geun; Lee, Byung Joo; Goh, Eui Kyung; Chon, Kyong Myong; Ahn, Hwoe Young

Abstract

BACKGROUND AND OBJECTIVES: Recurrent laryngeal papillomatosis (RRP) have been divided into juvenile or aggressive forms, and adult or non-aggressive forms. This study attempted to characterize these two forms of RRP in our series and to detect human papilloma virus (HPV) using polymerase chain reaction (PCR). MATERIALS AND METHOD: Authors reviewed the records of 60 patients treated for RRP over a 16-year period from 1983 to 1999 at the Department of otolaryngology, Pusan National University Hospital. Clinical parameters included sex, age, chief complains, location and type of lesion, tracheotomy state, number of operation, aggressiveness, outcome of treatment and complications after operation. Twenty-three paraffinembedded tissues were selected to PCR using type-specific primer pairs.
RESULTS
1) Subglottic extension, tracheotomy, time of operation and aggressiveness were more common in juvenile form than the adult form. 2) The multiple type was also common in the adult form. 3) Non-aggressive and single types showed better response for treatment. 4) There are no significant differences of cure rate according to age and treatment modality, but preoperative alpha-interferon therapy showed more effective in the case of compromised airway. 5) HPV type 6, 11 in 10 cases(43.5%) were detected out of 23 cases. Most detected cases were non-improvement group.
CONCLUSION
The significant difference of treatment results are found in comparison between aggressive and non-aggressive forms and alpha-interferon may be an effective therapy for aggressive respiratory papillomatosis. HPV subtype may be related to the prognosis factor.