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Recurrent Respiratory Papillomatosis

Primarily affecting the vocal cords and larynx (voice box), recurrent respiratory papillomatosis (RRP) is disease that can cause voice, breathing, and swallowing issues. Caused by the human papilloma virus (HPV), RRP produces, wart-like growths. When located in the throat, these growths may cause changes to the voice and breathing difficulties. Treatment involves surgery to remove the growths and may include medication to help prevent them from returning.

Signs and Symptoms of RRP

The most common symptom associated with RRP is a change in the voice. Papilloma grows directly on the vocal cord, causing a raspy and irregular voice. Other symptoms include:

  • Shortness of breath
  • Difficulty swallowing
  • Trouble breathing while sleeping
  • Chronic coughing

Diagnosis of RRP

Determining the source of hoarseness starts with a thorough examination of the throat and vocal cords. Laryngoscopy is a quick procedure where a small camera is place through the mouth or nose to view the vocal cords. Stroboscopy uses specialized light timed to the vibration of the vocal cords to even further analyze anatomy.

Treatment for RRP

Unfortunately, there is no way to completely "cure" RRP due to the nature of the condition. Treatment usually involves surgery to remove the growth, or papilloma. Removal was once routinely performed through the mouth while the patient was sedated. The surgeon would then use a camera to locate the growth, which was then removed with lasers and related instruments.

An increasingly common alternative is a minimally invasive procedure that accomplishes the same goal with the patient completely awake. A camera placed through the nose is used to view the papilloma. Lasers are used to remove the papilloma in a way that leaves sensitive vocal cord tissues alone. Unlike the traditional procedure, the minimally invasive technique is often performed in less than half an hour, does not require general anesthesia, and has a shorter recovery time.

The condition is referred to as being "recurrent" since growths often return even after initial surgery. Some follow-up treatments after surgery involve the use of certain medications to minimize the risk of the growths returning.

Periodic breakouts of recurrent respiratory papillomatosis may occur without any clear reason, which can sometimes make it difficult to manage the condition. While the resulting growths mostly occur around the larynx and vocal cords, RRP sometimes in other locations including nose, trachea, and lungs.