Laryngeal sequelae of recurrent respiratory papillomatosis surgery in children

OBJECTIVE: To evaluate laryngeal sequelae from surgical treatment of recurrent respiratory papillomatosis in children, as well as associated risk factors. METHODS: Case-control study. Medical record data analysis of 50 children with recurrent respiratory papillomatosis, divided into two groups: with...

Full description

Bibliographic Details
Authors: Hermann, Juliana Sato [UNIFESP], Pontes, Paulo [UNIFESP], Weckx, Luc Louis Maurice [UNIFESP], Fujita, Reginaldo Raimundo [UNIFESP], Avelino, Melissa Ameloti Gomes [UNIFESP], Pignatari, Shirley Shizue Nagata [UNIFESP]
Format: article
Status:Published version
Publication Date:2012
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/7053
Online Access:http://dx.doi.org/10.1590/S0104-42302012000200016
http://repositorio.unifesp.br/handle/11600/7053
Access Level:Open access
Keyword:Papilloma
postoperative complications
dysphonia
laser
therapy
papillomavirus infections
Description
Summary:OBJECTIVE: To evaluate laryngeal sequelae from surgical treatment of recurrent respiratory papillomatosis in children, as well as associated risk factors. METHODS: Case-control study. Medical record data analysis of 50 children with recurrent respiratory papillomatosis, divided into two groups: with and without laryngeal sequelae. The group of patients with laryngeal sequelae was compared to those without sequelae in regard to the onset of disease, age at first surgery, number and frequency of surgeries, disease stage, and type of surgery (CO2 laser, cold forceps). RESULTS: 23 patients (46%) sustained laryngeal sequelae. The most frequent sequela was anterior commissure synechia (17 patients [34%]), followed by glottic stenosis (six patients [12%]). There was no statistically significant difference between groups with and without laryngeal sequelae regarding the disease onset (p = 0.93), age at first surgery (p = 0.68), number of surgeries (p = 0.22), annual frequency of surgery (p = 0.93), presence of papilloma in anterior (p = 0.430) or posterior commissure (p = 0.39), and type of surgery (p = 0.27). The Derkay anatomical score (a staging system that assesses the extent of the disease in the aerodigestive tract) was significantly higher in the laryngeal sequelae group (p = 0.04). CONCLUSION: Laryngeal sequelae are a frequent complication of recurrent respiratory papillomatosis surgical treatment in children, particularly anterior commissure synechiae and glottic stenosis. Advanced stages are associated with increased risk of laryngeal sequelae after surgery.