Recurrent Respiratory Papillomatosis: An Update

The aim of this article is to describe the pathogenesis, etiology, clinical course, prevention, and management of recurrent respiratory papillomatosis (RRP). RRP is a challenging chronic disease of the respiratory tract that occurs in both children and adults. It is caused by human papillomavirus (HPV), with more than 90% caused by HPV 6 and HPV 11 types. While there is no definitive treatment for RRP, the goal of treatment focuses on improving voice quality and maintaining airway patency. The clinical presentation is nonspecific with the majority of patients presenting with hoarseness, stridor, or dyspnea. Surgical management is the mainstay of treatment of RRP, and about 20% of the patients benefit from adjuvant therapies including cidofovir, bevacizumab, interferon, and others. Prevention of the disease with the HPV vaccine and practicing safe sex may play a major role in decreasing the incidence of HPV infection and RRP.