presentation and surgical intervention. [file.scirp.org]

Both patients with malignant transformation presented with an epidermoid carcinoma. [elsevier.pt]

Any child presenting with a voice disturbance with or without stridor is recommended to have diagnostic flexible fiber-optic laryngoscopy. [ncbi.nlm.nih.gov]

Among adults, the disease may be associated with oral-genital contact. 1 Affected children usually present with hoarseness and occasionally with stridor, cough, or recurrent pneumonia. [appliedradiology.com]

• Crying

  Papillomas are suspected when parents notice hoarseness, a weak cry, or other changes in the child’s voice. Papillomas reappear often and occasionally spread into the windpipe (trachea) and lungs, blocking the airway. [merckmanuals.com]

  Five patients, aged 2 to 6 years, were erroneously diagnosed with recurrent croup, asthma, laryngeal hemangioma, and tracheomalacia after presenting with variable degrees of chronic dyspnea, cough, stridor, dysphonia, weak cry, and syncope. [ncbi.nlm.nih.gov]

• Weakness

  Papillomas are suspected when parents notice hoarseness, a weak cry, or other changes in the child’s voice. Papillomas reappear often and occasionally spread into the windpipe (trachea) and lungs, blocking the airway. [merckmanuals.com]

  Five patients, aged 2 to 6 years, were erroneously diagnosed with recurrent croup, asthma, laryngeal hemangioma, and tracheomalacia after presenting with variable degrees of chronic dyspnea, cough, stridor, dysphonia, weak cry, and syncope. [ncbi.nlm.nih.gov]

• Fatigue

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: May 13, 2019 [patientslikeme.com]

  […] with recurrence In children without a response, stop administration Observe for rebound in RRP after discontinuation of alpha-interferon Side effects (frequent) Side effects frequently seen on initiation disappear with continued use (tachyphylaxis) Fatigue [medicine.uiowa.edu]

  Over the long term, the patients reported intermittent fatigue, occasional headache, and anorexia, and four patients had depression, although they did not require formal psychiatric intervention. [dx.doi.org]

  Common side effects of EGFR inhibitors include skin rash, hypomagnesemia, paronychia, fatigue, abdominal pain, nausea and diarrhea. [f1000research.com]

• Swelling

  Adverse effects reported included airway swelling requiring intubation in a child with severe RRP a few hours after photodynamic therapy. [ncbi.nlm.nih.gov]

  * (n) optic disk swelling (n) 視神経乳頭出血 * ししんけいにゅうとうしゅっけつ PubMed, Scholar, Google, WikiPedia 【類義語】 乳頭出血 optic disc hemorrhage * (n) 視神経乳頭障害 ** ししんけいにゅうとうしょうがい PubMed, Scholar, Google, WikiPedia optic disc disorder (n*) 視神経乳頭ドルーゼン * ししんけいにゅうとうどるーぜん シソーラス [lsd-project.jp]

  In practice, submucosal injection may cause temporary swelling of the vocal folds, with the risk of airway obstruction in infants with narrow airways. 63 More recently, administration of inhaled cidofovir has been reported and might offer further ground [dovepress.com]

• Falling

  Angelika Eichner, Mike Hänsel and Matthias Hübler, Fall 23 – Laseroperation, Komplikationen in der Anästhesie, 10.1007/978-3-662-43440-6_23, (251-261), (2014). [doi.org]

• Hoarseness

  In our patients the most frequent symptoms were hoarseness and dyspnea, revealing obstructive compromise of the airway by the papillomata. [elsevier.pt]

  Papillomas are suspected when parents notice hoarseness, a weak cry, or other changes in the child’s voice. Papillomas reappear often and occasionally spread into the windpipe (trachea) and lungs, blocking the airway. [merckmanuals.com]

  After surgical removal, the patient’s voice is commonly hoarse; however, they will be able to speak with greater amplitude than before. Unfortunately, in most cases, the growths will continue to reoccur after surgical removal. [ohniww.org]

  Recurrent respiratory papillomatosis is a relatively uncommon disease that presents clinically with symptoms ranging from hoarseness to severe dyspnea. [ncbi.nlm.nih.gov]

• Diarrhea

  Common side effects of EGFR inhibitors include skin rash, hypomagnesemia, paronychia, fatigue, abdominal pain, nausea and diarrhea. [f1000research.com]

  that disrupts DNA synthesis Indication May be beneficial for patients with recalcitrant papillomatosis Dosing (oral) Adults and children, 10 mg per kg, five times per day by mouth for 10 days then twice per day for six weeks Side effects Vomiting, diarrhea [medicine.uiowa.edu]

• Cesarean Section

  This child did not have the usual risk factors for recurrent respiratory papillomatosis, being the second child born by cesarean section to a mother without history of condyloma. [ncbi.nlm.nih.gov]

  In a study using data collected by the RRP Foundation, it was found that the number of JORRP patients born via cesarean section was less than 25% of the statistically expected number based on national normals, suggesting that a cesarean birth might play [rrpf.org]

  Ann Otol Rhinol Laryngol 2005;114:730-737 Kosko JR, Derkay CS: Role of cesarean section in prevention of recurrent respiratory papillomatosis Is there one?. [karger.com]

  Role of cesarean section in prevention of recurrent respiratory papillomatosis--is there one?. Int J Pediatr Otorhinolaryngol. 1996 Mar. 35(1):31-8. [Medline]. Shah KV, Stern WF, Shah FK, Bishai D, Kashima HK. [emedicine.medscape.com]

• Genital Lesions

  HPV is thought to be acquired at the time of vaginal delivery in the presence of genital lesions, and patients typically present with symptoms of hoarseness or respiratory obstruction in childhood or adolescence. [nature.com]

• Asthenia

  Preoperative and postoperative Grade, Roughness, Breathiness, Asthenia, and Strain Scale, videostroboscopic findings, aerodynamic and acoustic parameters, and self-assessment questionnaires were measured and compared with an age- and sex-matched control [ncbi.nlm.nih.gov]

Preoperative Workup Blood pressure and heart rate measurements before the procedure. [csurgeries.com]

Microdirect Laryngoscopy (Suspension Microlaryngoscopy or Direct Laryngoscopy) Good example of positioning/setup: Microdirect Laryngoscopy case example Repeat DL/B with videorecording at least every eight to 12 weeks Baseline CXR, repeated annually Additional workup [medicine.uiowa.edu]

An extensive workup has not found a source of blood loss. [f1000research.com]

Clinical Testing and Workup An indirect laryngoscopy involves holding a small mirror in the back of the throat. An ENT physician will reflect light off the mirror to illuminate the throat and detect the presence of papillomas. [rarediseases.org]

If advancing degrees of atypia are found, closer observation and further workup is mandated. CLINICAL PRESENTATION The initial disease presentation and subsequent clinical course in adult RRP compared with childhood-onset RRP is markedly different. [journals.lww.com]

• Atelectasis

  Changes secondary to pulmonary papillomatosis included atelectasis, infection and bronchiectasis. Respiratory papillomatosis involving pulmonary parenchyma is associated with a poor prognostic outcome. [ncbi.nlm.nih.gov]

  Enlargement of a previously described lesion and mediastinal lymphadenopathy should increase the suspicion of malignancy. 6 In addition, parenchymal complications, such as pneumonia, abscess, and atelectasis, can be seen. [appliedradiology.com]

This additional treatment can be performed either in the operating room along with KTP laser treatment or, in many patients, as an office-based procedure. [northshore.org]

complications of the endoscopic treatment, malignant transformation and mortality. [elsevier.pt]

Although some tumors may begin to disappear at puberty, treatment of recurrent respiratory papillomatosis is recommended. Surgical removal is the usual treatment. [merckmanuals.com]

Acyclovir in the treatment of recurrent respiratory papillomatosis. A pilot study. Ann Otol Rhinol Laryngol. 1994 Apr. 103(4 Pt 1):301-5. [Medline]. [emedicine.medscape.com]

Therefore, we designed the scheduled protocol for treatment of RRP with increasing treatment intervals. The dose was kept at 1 mg/kg but after 4 treatments at 2-week intervals, each subsequent treatment interval was increased by 1 week. [dx.doi.org]

Prognosis The prognosis is often good and morbidity low in most cases. Younger children, especially those under the age of 3 years, and adults with HPV-11 infection generally experience a more severe disease course. [orpha.net]

Although previous reports suggest a poor prognosis for lung cancer associated with papillomatosis, we have successfully treated 1 such patient, who presented with three synchronous pulmonary malignancies, using parenchyma-sparing resection techniques. [ncbi.nlm.nih.gov]

What is the prognosis/outlook? Because there is no cure yet, the prognosis is guarded. Patients can certainly live full lives, but often require repeated procedures over time to remove the growths. [chicagovoicecare.com]

The etiology, medical and physical therapeutic management, anesthetic management, and complications of patients with RRP are presented. [ncbi.nlm.nih.gov]

A literature search was performed to characterize the epidemiology, imaging findings and management of this condition. The patient underwent 30 courses of surgery over 21 years and presented disseminated pulmonary papilloma after childbirth. [ncbi.nlm.nih.gov]

DERKAY, Epidemiology of recurrent respiratory papillomatosis, APMIS, 118, 6‐7, (450-454), (2010). [dx.doi.org]

Epidemiology of recurrent respiratory papillomatosis. APMIS. 2010 ;118(6-7): 450 - 454. Google Scholar | Medline | ISI [oadoi.org]

The peer-reviewed literature was culled to provide a comprehensive review encompassing AO-RRP and anogenital papilloma, as well as general HPV virology and pathophysiology. PubMed and Google Scholar databases were searched from 1975 to July 2014. [ncbi.nlm.nih.gov]

Evidence Review The peer-reviewed literature was culled to provide a comprehensive review encompassing AO-RRP and anogenital papilloma, as well as general HPV virology and pathophysiology. [doi.org]

Pathophysiology HPV, the virus associated with cutaneous warts, genital condyloma, and cervical cancer, causes RRP. While more than 20 types of HPV can cause genital warts, only 2 of these, HPV-6 and HPV-11, cause the vast majority of cases of RRP. [emedicine.medscape.com]

Functionally, these groupings correlate with their tissue preference as well as similar pathophysiology. 16 The HPVs are members of a large family of papillomaviruses that infect vertebrates ranging from birds to humans, causing epithelial neoplasms that [clinicalgate.com]

Although cesarean section may prevent the exposure of children to the HPV virus during childbirth, its effectiveness in preventing RRP is debatable and the procedure itself carries an increased risk of complications. [ncbi.nlm.nih.gov]

In severe cases, anti-viral medications are used in conjunction with surgical removal to help prevent the regrowth of papilloma. These medications include Interferon and Cidofovir, which prevent the growths from copying themselves and growing. [ohniww.org]

Prevention: HPV vaccine The HPV vaccine is effective in preventing the virus that causes recurrent respiratory papillomas. [chop.edu]