Nationwide Survey on Incidence and Management of Recurrent Respiratory Papillomatosis in Japan.

Objectives: To investigate the incidence, laryngeal distribution, management, and postoperative clinical course of patients with newly diagnosed adult-onset recurrent respiratory papillomatosis (RRP) in Japan.

Methods: An initial brief questionnaire was sent to 782 institutions, including all 101 core and 627 collaborating institutions providing board certification programs accredited by the Japanese Society of Otorhinolaryngology-Head and Neck Surgery. A detailed questionnaire regarding patient age, sex, Derkay's score, surgery, and postoperative clinical course was sent to 196 institutions caring for patients with either newly or previously diagnosed RRP.

Results: A total of 186 patients with newly diagnosed adult-onset RRP from 78 institutions were identified during the present study period (2018-2019), suggesting an annual incidence of 0.20 per 100,000 population in Japan. The true vocal folds were the most frequently affected subsites in the larynx, followed by the false vocal folds, anterior commissure, and laryngeal surface of the epiglottis. The use of cold instruments was the most preferred surgical approach, followed by the carbon dioxide laser and microdebrider. A significant difference in recurrence-free period after the initial surgery was observed between patients with lesions in a single region and those with lesions in multiple regions (p = 0.001).

Conclusion: Here, we estimated the annual incidence of adult-onset RRP for the first time in Japan. To the best of our knowledge, the present study is the largest to identify the laryngeal distribution of lesions, as well as postoperative outcomes after initial surgery in newly diagnosed adult-onset RRP patients.

Level of evidence: 4 Laryngoscope, 2024.