Manickavasagam J, Wu K, Bateman N D
Department of Otorhinolaryngology and Head and Neck Surgery, Royal Hallamshire University Hospital & Sheffield Childrens Hospitals, Sheffield, UK.
J Laryngol Otol. 2013 Sep;127(9):917-21. doi: 10.1017/S0022215113001588. Epub 2013 Aug 8.
Recurrent respiratory papillomatosis is the most common benign neoplasm of the larynx in children. Intralesional injection of cidofovir may have some potential as an adjunctive treatment. There is no standardised protocol in the UK for the management of recurrent respiratory papillomatosis. This study aimed to investigate the management practices of surgeons treating paediatric recurrent respiratory papillomatosis in the UK.
A web questionnaire survey was sent by e-mail to all members of the British Association of Paediatric Otorhinolaryngology.
Out of 35 respondents, 23 were at that time treating children with recurrent respiratory papillomatosis. Nineteen respondents preferred to use a microdebrider, 12 preferred laser, and 5 preferred cold steel along with either laser or a microdebrider. Twelve surgeons used cidofovir for selected patients and 12 surgeons did not use cidofovir for any patients. Cidofovir was considered after 0–4 surgical procedures by seven respondents, after 4–6 surgical procedures by four respondents and after 6 surgical procedures by six respondents. Eleven respondents warned patients about the possible side effects of cidofovir and five gave no warning.
There was no consensus as to when it would be appropriate to use cidofovir, indicating the need for cidofovir usage guidelines.
复发性呼吸道乳头状瘤病是儿童最常见的喉部良性肿瘤。病灶内注射西多福韦作为辅助治疗可能具有一定潜力。在英国,对于复发性呼吸道乳头状瘤病的管理尚无标准化方案。本研究旨在调查英国治疗儿童复发性呼吸道乳头状瘤病的外科医生的管理实践。
通过电子邮件向英国儿科耳鼻咽喉科协会的所有成员发送了一份网络问卷调查。
在35名受访者中,有23人当时正在治疗患有复发性呼吸道乳头状瘤病的儿童。19名受访者更喜欢使用微型清创器,12名更喜欢激光,5名更喜欢冷器械以及激光或微型清创器。12名外科医生为部分患者使用了西多福韦,12名外科医生未对任何患者使用西多福韦。7名受访者在0至4次手术操作后考虑使用西多福韦,4名受访者在4至6次手术操作后考虑使用,6名受访者在6次手术操作后考虑使用。11名受访者向患者告知了西多福韦可能的副作用,5名未作告知。
对于何时适合使用西多福韦尚无共识,这表明需要制定西多福韦的使用指南。