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Respiratory papillomatosis is caused by HPV. The most common location in head and neck is larynx, palatine tonsils and arches of palate, uvula and mucosa oral and nasal cavity. The disease is benign but recurrent. The aim of this study was to estimate new methods of treatment respiratory papillomatosis based on intralesional injection of cidofovir into sites where papillomas had just been excised. The purpose of the study were 59 patients treating in Otolaryngology Clinic Stomatology Department Medical University of Warsaw. The treatment was based on surgical excision of papilloma and after it intralesional injection of cidofovir in after 4–5 weeks. We observed the patients during 28 months. 41 patients had 4 times intralesional injection of cidofovir. 18 patients had increased number of injection of ciodofovir because of recurrent papilloma. Rest of this group of the patients clinical studies showed remission disease. Surgery with intralesional cidofovir injection in the place after removal of papilloma is very effective methods. We observed that this treatment caused long lasting remission of papilloma recurrence.Keywords:
Cidofovir
Recurrent Respiratory Papillomatosis
Papillomatosis
Recurrent respiratory papillomatosis is caused by the Human Papilloma Virus and occurs primarily in children and adolescence. Most commonly, disease remains localized to the larynx and spontaneously regresses, but in rare cases there may be pulmonary involvement. We present a case of a 17 year old female with recurrent respiratory papillomatosis who develops pulmonary involvement in the form of squamous papilloma. We present the clinical findings; discuss the potential for malignant transformation and the need for screening and prevention. Keywords: Respiratory papillomatosis, recurrent tracheal papillomatosis, squamous papilloma
Recurrent Respiratory Papillomatosis
Papillomatosis
Malignant Transformation
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Respiratory papillomatosis is caused by HPV. The most common location in head and neck is larynx, palatine tonsils and arches of palate, uvula and mucosa oral and nasal cavity. The disease is benign but recurrent. The aim of this study was to estimate new methods of treatment respiratory papillomatosis based on intralesional injection of cidofovir into sites where papillomas had just been excised. The purpose of the study were 59 patients treating in Otolaryngology Clinic Stomatology Department Medical University of Warsaw. The treatment was based on surgical excision of papilloma and after it intralesional injection of cidofovir in after 4–5 weeks. We observed the patients during 28 months. 41 patients had 4 times intralesional injection of cidofovir. 18 patients had increased number of injection of ciodofovir because of recurrent papilloma. Rest of this group of the patients clinical studies showed remission disease. Surgery with intralesional cidofovir injection in the place after removal of papilloma is very effective methods. We observed that this treatment caused long lasting remission of papilloma recurrence.
Cidofovir
Recurrent Respiratory Papillomatosis
Papillomatosis
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Introduction Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis (RRP), is caused by the Human Papilloma Virus (HPV). The role of HPV in the pathogenesis of sinonasal inverted papilloma is not yet fully understood. A synchronous occurrence was first described by Oliver et al. in 2019.
Recurrent Respiratory Papillomatosis
Papillomatosis
Inverted Papilloma
Pathogenesis
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Hintergrund: Die Behandlung der rezidivierenden Larynxpapillomatose stellt nach wie vor ein großes therapeutisches Problem dar. Diese primär gutartige Erkrankung des Larynx wird infolge einer Infektion mit dem humanen Papilloma-Virus (HPV), welcher epitheliale neoplastische Polypen bildet, hervorgerufen. Therapeutisch erfolgt bei funktionell bedeutsamer Papillomatose meistens eine laserchirurgische Abtragung, die mit hohen Rezidivraten einhergeht. In ersten Pilotstudien wird derzeit die Wirksamkeit von Cidofovir, welches als Nukleosidanalogon virustatisch wirkt, insbesondere bei intraläsionaler Injektion des Larynx untersucht.
Cidofovir
Papillomatosis
Recurrent Respiratory Papillomatosis
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To evaluate the efficacy of cidofovir intralesional therapy in recurrent respiratory papillomatosis and the role of surgical excision as an associated treatment.Prospective study and case series.Twenty-six patients received intralesional cidofovir. Three endoscopies were performed at monthly intervals, with intralesion injections of cidofovir at 5 mg/mL. Further endoscopic evaluation was made at 3 or 6 months depending on whether there was persistent papillomatosis. Cidofovir was again injected in the case of persistent papillomas, and treatment was repeated as long as papillomas were observed. Surgical excision of the papilloma was only performed in cases of airway obstruction or in cases proving resistant to cidofovir.Complete remission was obtained in 8 (31%) patients after an average of 2.6 endoscopic treatment. Seventeen (65%) patients presented slight or mild disease at endpoint (final severity score 1-4). Significant results were obtained in both adults and children. A greater response was obtained in the supraglottis and glottis subsites than in subglottis, tracheal, and other sites. Patients conforming to the 1 month interinjection schedule showed better responses in supraglottis subsite than those receiving their injections with intervals longer than 1 month. Combined therapy (cidofovir plus excision) was necessary in persistent papillomas. No patients presented with any systemic or local side effects.Cidofovir therapy was an effective treatment in adults and in children, allowing papillomatosis to be controlled without observed side effects. Surgical excision associated with cidofovir injections remained necessary in persistent papillomatosis after cidofovir treatment.
Cidofovir
Recurrent Respiratory Papillomatosis
Papillomatosis
Subglottis
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An 8-year-old patient with severe recurrent respiratory papillomatosis and pulmonary spread was treated by systemic administration of cidofovir in association with laser treatment for tracheal lesions. Complete disappearance of the lesions in the pharynx and larynx and a significant yet incomplete regression in the bronchi and lung parenchyma were observed without deleterious side effects. This is the first case report of systemic use of cidofovir to treat recurrent respiratory papillomatosis.
Cidofovir
Recurrent Respiratory Papillomatosis
Papillomatosis
Respiratory tract
Parenchyma
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Cidofovir
Papillomatosis
Recurrent Respiratory Papillomatosis
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We sought to determine the efficacy of intralesional injection of cidofovir in improving resolution of recurrent respiratory papillomatosis (RRP). Study design and setting We conducted a prospective, observational trial at an academic tertiary children's hospital.Four children with RRP requiring more than 6 surgical excisions per year were treated with intralesional cidofovir. Cidofovir (5 mg/mL) was injected into airway sites where papillomas had just been excised using sharp technique. Each patient had 6 treatments performed 6 to 8 weeks apart. Biopsies confirmed benign papilloma lesions in all cases. During treatment with intralesional cidofovir there was diminished growth of the papillomas in each patient. Once cidofovir treatment was stopped, the rate of regrowth and frequency of surgical excision returned to pretreatment levels in 3 of the 4 patients.Intralesional cidofovir may provide benefit in reducing the rate of RRP growth while under treatment, but RRP severity returned to pretreatment levels once cidofovir treatment was stopped using this treatment program.
Cidofovir
Recurrent Respiratory Papillomatosis
Papillomatosis
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Recurrent respiratory papillomatosis (RRP) is a rare disease in children and adults. It is characterized by proliferation of benign squamous cell papillomas within the respiratory-digestive tract, predominantly the larynx. Standard treatment consists of surgical excision of papillomata to maintain airway patency and voice quality. For last several years cidofovir is the most contemporary adjuvant anti-viral treatment for recurrent respiratory papillomatosis and its topical use is widely described.Intralesional cidofovir therapy was given to 20 patients treated for laryngeal papillomas in the Department of Otolaryngology in Poznan between I-XII.2009. The character of the lesion differed: from one anatomical site and moderate growth to four or five localizations with heavy extension. The number of cidofovir injections per patient varied from one to six times and the volume of solution ranges from 1-12 ml. The cidofovir injections were combined with laser or mechanical excision of the lesions. In disperse papillomata the injections administered in particular anatomical sites in 4-6 weeks period. In massive lesions injections were repeated in the same anatomical site.Complete remission was observed in 3 out of 20 patients. 12 patients show remission in a place of cidofovir injection. In 4 patients during the 4 week observation new foci of papillomatosis occurred. In two patients hepatic toxic side effect were observed.Intralesional cidofovir injection has been shown to be an effective an safe therapy for laryngeal papilloma and should be considered in those patients who experienced disease relapse.
Cidofovir
Recurrent Respiratory Papillomatosis
Papillomatosis
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Cidofovir
Recurrent Respiratory Papillomatosis
Papillomatosis
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