Szyfter Witold, Wierzbicka Małgorzata, Jackowska Joanna, Bartochowska Anna, Banaszewski Jacek
Katedra i Klinika Otolaryngologii i Onkologii, Laryngologicznej UM w Poznaniu.
Otolaryngol Pol. 2010 Mar-Apr;64(2):98-102. doi: 10.1016/S0030-6657(10)70043-3.
Recurrent respiratory papillomatosis (RRP) is a rare disease in children and adults. It is characterized by proliferation of benign squamous cell papillomas within the respiratory-digestive tract, predominantly the larynx. Standard treatment consists of surgical excision of papillomata to maintain airway patency and voice quality. For last several years cidofovir is the most contemporary adjuvant anti-viral treatment for recurrent respiratory papillomatosis and its topical use is widely described.
Intralesional cidofovir therapy was given to 20 patients treated for laryngeal papillomas in the Department of Otolaryngology in Poznan between I-XII.2009. The character of the lesion differed: from one anatomical site and moderate growth to four or five localizations with heavy extension. The number of cidofovir injections per patient varied from one to six times and the volume of solution ranges from 1-12 ml. The cidofovir injections were combined with laser or mechanical excision of the lesions. In disperse papillomata the injections administered in particular anatomical sites in 4-6 weeks period. In massive lesions injections were repeated in the same anatomical site.
Complete remission was observed in 3 out of 20 patients. 12 patients show remission in a place of cidofovir injection. In 4 patients during the 4 week observation new foci of papillomatosis occurred. In two patients hepatic toxic side effect were observed.
Intralesional cidofovir injection has been shown to be an effective an safe therapy for laryngeal papilloma and should be considered in those patients who experienced disease relapse.
复发性呼吸道乳头状瘤病（RRP）在儿童和成人中是一种罕见疾病。其特征是呼吸道 - 消化道内，主要是喉部出现良性鳞状细胞乳头状瘤增生。标准治疗方法是手术切除乳头状瘤以维持气道通畅和嗓音质量。在过去几年中，西多福韦是复发性呼吸道乳头状瘤病最现代的辅助抗病毒治疗药物，其局部应用已有广泛描述。
2009年1月至12月期间，在波兹南耳鼻喉科，对20例接受喉部乳头状瘤治疗的患者进行了病灶内注射西多福韦治疗。病变特征各异：从一个解剖部位且生长适度到四五个部位且广泛蔓延。每位患者西多福韦注射次数从1次到6次不等，溶液体积为1 - 12毫升。西多福韦注射与激光或机械切除病变相结合。对于散在的乳头状瘤，在4 - 6周内于特定解剖部位进行注射。对于广泛病变，在同一解剖部位重复注射。
20例患者中有三例完全缓解。12例患者在西多福韦注射部位出现缓解。4例患者在4周观察期内出现新的乳头状瘤病灶。2例患者观察到肝脏毒性副作用。
病灶内注射西多福韦已被证明是治疗喉部乳头状瘤的一种有效且安全的疗法，对于经历疾病复发的患者应予以考虑。
