Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, 85-168 Bydgoszcz, Poland.
Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No. 2, 85-168 Bydgoszcz, Poland; Department of Otolaryngology, Phoniatrics and Audiology, Collegium Medicum, Nicolaus Copernicus University, 85-168 Bydgoszcz, Poland.
Oral Oncol. 2024 Nov;158:107004. doi: 10.1016/j.oraloncology.2024.107004. Epub 2024 Aug 19.
Recurrent respiratory papillomatosis is medical condition strictly connected with HPV infection of the epithelium of the upper respiratory track. The main treatment of lesions located in larynx or lower pharynx includes microsurgical excision by using CO2 laser. A thorough preoperative assessment of patients is extremely important, which should not only be based on traditional laryngological examination, but also on endoscopy of the larynx and the use of the NBI (narrow band imaging) technique to assess the vascularization of lesions. In patients with recurrent papillomas, neoadjuvant therapy with antiviral agents or agents that inhibit angiogenesis is also often used. Among our group of 31 patients with laryngeal papillomas, 15 people (48%) required repeated surgical intervention and additional antiviral therapy while 10 (33%) people had to undergo the procedure three or more times due to disease recurrence. In this article we will discuss that laryngeal microsurgery with a CO2 laser is an effective method of treating patients with laryngeal papillomatosis and we will present the possibilities of adjuvant therapy.
复发性呼吸道乳头瘤病是一种与 HPV 感染上呼吸道上皮密切相关的医学病症。位于喉部或下咽部的病变的主要治疗方法包括使用 CO2 激光进行显微切除。对患者进行彻底的术前评估非常重要,不仅应基于传统的喉镜检查,还应进行喉内窥镜检查和使用 NBI(窄带成像)技术评估病变的血管生成。对于复发性乳头状瘤患者,还经常使用抗病毒药物或抗血管生成药物进行新辅助治疗。在我们的 31 例喉部乳头状瘤患者中,15 人(48%)需要反复进行手术干预和额外的抗病毒治疗,而 10 人(33%)由于疾病复发需要进行 3 次或更多次手术。在本文中,我们将讨论 CO2 激光喉显微手术是治疗喉乳头状瘤患者的有效方法,并介绍辅助治疗的可能性。