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Papilloma

Papilloma is a warty growth caused by the Human Papilloma Virus. Human Papilloma Virus is the name of a group of viruses that includes more than 100 different types (strains). Different strains of the virus cause similar warty growths in various parts of the body including the skin and genitals. These growths are referred to as Papillomas (also known as warts).

Although Papillomas can develop on any part of the respiratory tract, they are commonly found in the larynx (Laryngeal Papilloma), and often on the vocal folds themselves. The Papilloma virus is transmitted from person to person by intimate contact. Fortunately, not everyone who comes into contact with the virus develops Papillomas. The reason for the difference in the susceptibility to developing a Papilloma is unclear. It is thought that the individual’s immune system plays a role in this. Voice use has no bearing on the formation of papillomas.

Symptoms:

The main symptom is painless hoarseness. The presence of Papillomas disturbs the normal vibration and closure of the vocal folds resulting in hoarseness. Larger lesions can obstruct the larynx resulting in difficulty breathing.

Laryngeal Papillomas are seen more in young children, who are exposed to the Human Papilloma Virus (genital warts) during passage through the birth canal. Adults often acquire Papillomas through intimate contact. Growths in adults are generally less aggressive than in children as the Papillomas in adults grow slower and are less likely to grow outside of the larynx.

Treatment:

There is no cure for Laryngeal Papillomas. Surgical removal of the Papilloma helps to alleviate symptoms and remains the mainstay of treatment. Papillomas are very resilient lesions which tend to grow back no matter how completely they are removed. Patients may require multiple procedures, no matter how complete the excision.

There are many different techniques for removal of Papillomas, none of which has been proven to be superior. In removing Papillomas, it is essential to cause minimal damage to surrounding structures in order to prevent scarring that may lead to hoarseness or breathing difficulties. For patients with recurrent disease, the risks of surgery must be carefully weighed against the benefits of repeat excision of the Papillomas. For those who require frequent surgeries because of aggressive disease, investigational therapy may be considered.

Overall, patients with milder forms of Laryngeal Papillomas do well and eventually the disease goes into remission. The rare patients with severe disease may need lifelong frequent therapy.