Laser ablation of recurrent laryngeal papillomas in children.

Papillomas are the most common laryngeal tumors in childhood, and their etiology is thought to be viral. Papillomatosis (ie, widespread, multiple papillomas) may involve a child's airway from the epiglottis to the bronchi. Hoarseness is an early sign of juvenile laryngeal papillomas (JLP), and airway obstruction is a later, life-threatening sign. The recurrence and spread of JLP is common. An otorhinolaryngologist may perform a tracheostomy on a child with JLP; however, this procedure is avoided if possible, because a tracheostomy predisposes the trachea to papilloma seeding. Laser ablation of papillomas through the use of rigid endoscopic equipment and a carbon dioxide laser is the mainstay of therapy.