Papaioannou V-A, Lux A, Voigt-Zimmermann S, Arens C
Department of Otorhinolaryngology, Magdeburg University Hospital, Leipziger Straße 44, 39120, Magdeburg, Germany.
Institute for biometry and medical informatics, Magdeburg University Hospital, Magdeburg, Germany.
HNO. 2018 Jan;66(Suppl 1):7-15. doi: 10.1007/s00106-017-0378-0.
Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease of viral etiology which is characterized by multiple, recurrent growth of papillomas in the aerodigestive tract.
The surgical outcomes and the recurrence rates of 106 patients with RRP of the larynx were analyzed. The patients were treated at the University of Magdeburg between 1983 and 2014. The surgical outcomes of conventional and laser surgery regarding time to relapse and complications were compared. In addition, the influence of the quadrivalent vaccine Gardasil® on the disease was analyzed in 10 patients.
Children with RRP had a statistically significant greater number of surgeries throughout their lifetimes compared to adult patients. There were no differences between the adult (n = 79) and juvenile (n = 27) groups in the time to relapse and the number of surgeries/year. The time to relapse and number of procedures/year were not influenced by the various surgical methods. Complications after conventional and laser surgery were not statistically different between the two groups. Serious complications and the need for a tracheotomy were only reported after conventional surgery. In the 10 patients who were immunized with Gardasil®, a statistically significant lower number of surgeries/year after vaccination was achieved.
RRP is a rare disease. Treatment requires experience and may be very difficult. The analysis of the course of the disease has shown that the treatment of choice is surgical excision with the CO laser combined with the quadrivalent or polyvalent vaccine. Consequent vaccination of both boys and girls has the potential to reduce the occurrence of RRP.
复发性呼吸道乳头状瘤病（RRP）是一种病因由病毒引起的罕见慢性疾病，其特征为在气道消化道中出现多个复发性乳头状瘤生长。
分析了106例喉RRP患者的手术结果和复发率。这些患者于1983年至2014年在马格德堡大学接受治疗。比较了传统手术和激光手术在复发时间和并发症方面的手术结果。此外，还分析了10例患者中四价疫苗加德西（Gardasil®）对该疾病的影响。
与成年患者相比，RRP患儿一生中接受手术的次数在统计学上显著更多。成年组（n = 79）和青少年组（n = 27）在复发时间和每年手术次数方面没有差异。复发时间和每年手术次数不受各种手术方法的影响。两组传统手术和激光手术后的并发症在统计学上无差异。仅在传统手术后报告了严重并发症和气管切开的需求。在10例接种加德西疫苗的患者中，接种后每年手术次数在统计学上显著减少。
RRP是一种罕见疾病。治疗需要经验且可能非常困难。对疾病病程的分析表明，首选治疗方法是用CO激光进行手术切除并联合四价或多价疫苗。对男孩和女孩进行后续接种有可能减少RRP的发生。
