Pathogenesis and treatment of juvenile onset recurrent respiratory papillomatosis
Otolaryngologic Clinics of North America
Juvenile onset recurrent respiratory papillomatosis is a rare disease caused by infection of the human papillomavirus. There is much reason for optimism toward improved treatment for a greater number of children with JORRP. The complete genetic structure of the etiologic agent, the human papillomavirus, is known, and the mechanisms by which this virus can induce tumors are being elucidated. Novel, more specifically directed agents show promise in preliminary studies. Concurrently, there is an increasing awareness of methods to reduce surgical morbidity. Although frequent surgical procedures may be needed to maintain a clear airway and prevent asphyxiation, adjuvant medical treatments are effective in many cases in improving the course of recalcitrant disease. Current treatments include medications with minimal side effects (such as indole 3-carbinol/diindolylmethane) and agents proven to be effective in multiinstitutional prospective studies. The role of preventive efforts, including elective cesarian section, remains uncertain. Through national coordination of treatment efforts, identification of more effective agents leads to an improved prognosis for children with JORRP.
Green, G., Bauman, N., & Smith, R. (2000). Pathogenesis and treatment of juvenile onset recurrent respiratory papillomatosis. Otolaryngologic Clinics of North America, 33 (1). http://dx.doi.org/10.1016/S0030-6665(05)70215-2