Johnson Kaalan, Derkay Craig
Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
Otolaryngol Clin North Am. 2009 Feb;42(1):57-70, viii. doi: 10.1016/j.otc.2008.09.007.
Recurrent respiratory papillomatosis (RRP) is a chronic, frequently debilitating, and potentially life-threatening disease. Therapy for RRP has evolved from simply inserting a tracheotomy to provide an airway and plucking out papillomata with cup forceps to provide some degree of voice to the present-day far more sophisticated approaches, along with preventative measures that may someday offer the potential dramatically to decrease disease prevalence. Family dynamics and support and intentional structuring of office protocols to accommodate the unique nature of RRP are as essential as any operative intervention for saving and prolonging life. This article reviews recent developments in the management of RRP and highlights palliative approaches to case management for those patients who are not easily cured with initial endoscopic interventions.
复发性呼吸道乳头状瘤病(RRP)是一种慢性、常使人衰弱且可能危及生命的疾病。RRP的治疗方法已从单纯插入气管切开术以提供气道,并用杯状镊子拔除乳头状瘤以恢复一定程度的发声,发展到如今更为复杂的方法,同时还有一些预防措施,有望在未来大幅降低疾病的发病率。家庭动态、支持以及为适应RRP的独特性质而特意制定的办公室诊疗规程,与任何挽救和延长生命的手术干预同样重要。本文回顾了RRP治疗的最新进展,并着重介绍了对于那些初始内镜干预不易治愈的患者的姑息性病例管理方法。