Recurrent respiratory papillomatosis in Jos, Nigeria: Clinical presentation, management and outcome

Abstract

Background: Recurrent respiratory papillomatosis is a benign neoplastic disease of viral aetiology which can have significant morbidity or mortality and presents great challenges in it management. This study evaluates our experience with the management of this disease.
Methods: This was a 10 year retrospective review of 29 patients with histologically confirmed recurrent respiratory papillomatosis managed in the Jos University Teaching Hospital, Jos, Nigeria.
Results: Twenty nine patients aged between 2 months and 45 years were studied. There were 21(72.4%) males and 8 (27.6%) females. The highest incidence (62.1%) was in children less than 10 years.The presenting features were hoarseness in all patients and dyspnea in 28 (96.6%) patients who had emergency tracheostomy. Twenty five (89.3%) patients were decannulated within 1 week. No patient had distal viral spread. Twenty three (79.3%) patients presented within 10 months of onset of symptoms and 6 (20.7%) patients after this period.All the patients had endoscopic surgical excision. The commonest site of lesions was the vocal cords in 16 (55.2%) patients and the anterior commissure in 13 (44.8%) patients. Recurrence occurred in 2 (6.9%) patients. No malignant transformation occurred.
Conclusion: Conventional endoscopic surgical excision is safe and tracheostomy when needed is recommended in the  management of patients with recurrent respiratory papillomatosis.