Recurrent Respiratory Papillomatosis

Recurrent respiratory papillomatosis (RRP) is a rare disease that continues to cause significant morbidity and occupies a disproportionate amount of otolaryngology care relative to its incidence. As there is no cure for the disease process once it has manifested, recent efforts continue to focus on treatment modalities that delay papilloma re-growth. Systemic bevacizumab has been used off-label in severe cases of juvenile RRP with profound reduction in disease volume; however, it requires maintenance therapy of unknown duration. An international adoption of HPV vaccination has led to a decreased incidence of RRP and could potentially eradicate the disease entirely if herd immunity is reached in the USA. RRP remains a disease with significant morbidity and few successful long-term treatment modalities. For severe cases, systemic bevacizumab shows promise, but comes at significant cost. Ultimately, nationwide HPV vaccination will be the most successful measure to eradicate this disease entirely.