Laryngeal papillomatosis in a 3 year old infant: surgical and anesthesiological management.

Abstract

Juvenile-Onset recurrent respiratory papillomatosis (JO- RRP) is the most frequent benign neoplasm in children with tendency to recur. Human Papilloma Virus (HPV) types 6 and 11 are involved in its etiology. Maternal transmission during the passage through the birth canal is the most frequent modality of infection. Clinical mani- festations of JO-RRP may include dysphonia, dysphagia, hoarseness, cough and, in the most severe cases, respira- tory distress. We report a case of a 3-year-old infant with a history of hoarseness and persistent dysphonia. Laryn- goscopy showed diffuse papillomatous warts involving the glottic space and the false vocal cords. An accurate preoperative anesthesiological evaluation was provided. Surgical intervention in microlaryngos- copy was performed under general anaesthesia. Removal of the papillomatous warty growths in micro- laryngoscopy was achieved, with significant improve- ment of the glottic space. No intraoperative or postoper- ative complications occurred, the patient resumed per os feeding on the same day and was discharged the second postoperative day. At the follow up visit at 1-month, im- portant improvement of the voice quality was evident; laryngoscopy showed the absence of pathology; a strict follow up was planned in order to detect any recurrences.

Keywords

• laryngeal papillomatosis – papilloma virus – upper air- ways management - anesthesia in children – pediatric in- fection – vocal cords.