Recurrent Respiratory Papillomatosis: Updates on Diagnosis and Management

PROGRAM DESCRIPTION: Recurrent respiratory papillomatosis (RRP), characterized by benign squamous papillomas in the aerodigestive tract, is a potentially devastating disease in affected patients. RRP usually presents in children under age 12 years or in adults age 20-40 years. Although incidence has decreased since the introduction of the human papillomavirus (HPV) vaccine, RRP is still the most commonly diagnosed pediatric benign laryngeal lesion. Due to its predilection for multiple sites of the airway and the need for repeat procedures, it is a particularly expensive disease to treat, resulting in $120 million healthcare costs per year in the United States. Additionally, patients with RRP tend to report lower quality of life and depression, and there can often be a stigma surrounding this disease given its association with HPV. Given its presenting symptoms of hoarseness or dyspnea, patients with RRP often first present to otolaryngologists, who play a crucial role in diagnosis and management for patients with RRP. Thus, the aim of this panel is to review advances in treatment for RRP, how to overcome barriers to successful treatment, the state of HPV vaccination, and how to thoughtfully advise patients and their families dealing with this difficult disease process. Panelists include otolaryngologists who have family members with the disease and who have spent their careers investigating novel therapeutic modalities, including cidofovir, intravenous bevacizumab and anti-tumor vaccines. They will also provide perspectives on treating both adults and children with this challenging disease.

OUTCOME OBJECTIVE 1: Explain treatment modalities for RPP, including novel therapies such as intravenous bevacizumab and therapeutic vaccines

OUTCOME OBJECTIVE 2: Recognize the stigma that can accompany diagnosis and treatment of RRP and sensitively counsel patients

OUTCOME OBJECTIVE 3: Navigate barriers to access and care for patients

BACKGROUND STATEMENT: Review of treatment options for RRP and HPV vaccination given recent advances in the field, especially as antitumor vaccines may be FDA approved soon

Comprehensive Otolaryngology Track Statement :