Recurrent respiratory papillomatosis in the larynx: re-emergence of clinical disease following surgery.

The treatment and aetiology of recurrent respiratory papillomatosis remains unclear. We report a case of laryngeal papillomatosis where repeated suction diathermy and later laser treatment led to the formation of a substantial glottic web, but a clinically papilloma-free state of the upper aerodigestive system. Division of the web led to widespread recurrence of the papillomas, which eventually resolved after the larynx had healed with the reformation of a limited anterior web. The role of surgical trauma and its effect on re-emergence of papillomas is discussed.