Pediatric Laryngeal Papillomatosis: Experiences at an Indian Teaching Hospital

Abstract

Background and Aims: Laryngeal papillomatosis is an uncommon disease in pediatric age caused by the human papilloma virus, which presents as warty, exophytic growths in the larynx. Children having laryngeal papillomatosis frequently present with dysphonia. It can lead to severe airway obstruction and voice change. The aim of this study was to assess the detailed clinical presentations, treatment options, and outcome of the laryngeal papillomatosis in pediatric patients. Materials and Methods: This was a prospective study carried out among pediatric age group (n = 21) and among those who underwent surgical treatment with different modalities such as coblation, microdebrider, and laser on diagnosed cases of laryngeal papillomatosis during December 2015 to March 2019. Clinical presentations and detailed patient profile including maternal aspects were documented. Details of previous surgeries conducted on the child’s larynx were also recorded. Results: Dysphonia is the most common clinical presentation. Of 21 children, 12 were boys and 9 were girls. The mean age was 11.52 years. No child with a history of immunodeficiency or exposure to smoking was reported. Of 21 children, 9 had a history of previous surgeries for laryngeal papillomatosis. There were five primiparous mothers in this study and they are considered as as risk factors. One child underwent tracheostomy due to compromised airway by laryngeal papillomatosis. Coblation and microdebrider are common and effective techniques performed among children with laryngeal papillomatosis. Conclusion: Coblation and microdebrider were found to be safe and cost-effective than laser and coblation. Only maternal risk factor in this study was primiparous mother. Children with laryngeal papillomatosis were associated with multiple surgeries in the past due to recurrence and aggressive nature of the disease. Very young children and patients with tracheostomy needed strict follow-up in case of severe diseases.