Symptoms and General Pathology

All Conditions

Infections

Neoplasms

Rare Diseases

Recurrence

Virus Diseases

Papilloma

Neoplasms, Squamous Cell

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Recurrent Respiratory Papillomatosis

Laryngeal Papillomatosis

biopsy

Pavinee Intakorn, MD

The purpose of the present study was to identify risk factors for more severe juvenile Recurrent Respiratory Papillomatosis (RRP) through prospective evaluation of a pediatric population in Thailand by the employing a protocol that includes staging of disease severity using above mentioned staging system at the time of each endoscopic debridement, as well as human papilloma virus (HPV) genotyping.

Recurrent respiratory papillomatosis is caused by human papilloma virus and is the most common benign laryngeal neoplasm in children. Although RRP is rarely fatal, the disease requires prolonged, extensive medical and surgical treatment, and causes physical and emotional suffering in affected children and their families. Although recurrent respiratory papillomatosis is a relatively unusual problem, it accounts for significant health are expenditures.The goal of management of RRP is control of the disease, preservation of the voice and prevention of major complication .The purpose of study will identify risk factors for more severe juvenile RRP through prospective evaluation of a pediatric population in Thailand by the employing a protocol that includes staging of disease severity , as well as HPV genotyping.

Objective:

* To identify the genotypes of HPV isolated from Thai RRP patients
* To compare staging and severity with HPV genotypes
* To correlate the following characteristics of the Thai RRP patients with the HPV genotypes

Papillomatous tissue samples taken from endoscopic biopsies will be collected by the ENT specialists.Samples collected from the subjects will be analyzed for HPV genotype at the Unit of virology and molecular, Department of pathology, Faculty of medicine Ramathibodi hospital.

Human Papillomatosis Genotyping of Children in Thailand

Human Papillomatosis Genotyping and Severity in Patients With Recurrent Respiratory Papillomatosis of Children in Thailand

Distribution of Human papillomavirus(HPV) genotypes identified in the biopsy

We compared disease severity(Cotreta-Derkay score) between groups of children with two different HPV genotypes

Coltera and Derkay have evolved a staging system to stage recurrent papillomatous lesions involving the respiratory tract.

Coltera-Derkay method of staging :

Clinical score:

1. Voice: Normal - 0, Abnormal - 1, Aphonia - 2
2. Stridor: Absent - 0, Present on activity - 1, Present at rest - 2
3. Respiratory distress - None - 0, Mild - 1, Moderate - 2, Severe - 3, Extreme - 4.

Anatomical score:

For each site - 0 = none, 1=surface lesion, 2= raised lesion, 3=bulky lesion.

Total score = Anatomical score + Total clinical score

Merck Sharp & Dohme LLC

Queen Sirikit National Institute of Child Health

department of otorhinolarngology

Since this is the observational study, therefore the study process did not pose any risk to the participants (population at risk = 0)

Children hospitalized with recurrent respiratory papillomatosis who underwent biopsy

Children With Recurrent Respiratory Papillomatosis

Age, Continuous

Sex: Female, Male

Race (NIH/OMB)

Children With Recurrent Respiratory Papillomatosis in Thailand

The number of patients participating in this study was low , so additional studies should be conducted to make the research more effective.

Dr.Pavinee Intakorn

HPV type 6

HPV type 11

We found positive HPV DNA in all children. HPV type 6 and HPV type 11 caused recurrent respiratory papillomatosis in 6 (40%) and 9(60%) of cases,respectively.

Spots Global Cancer Trial Database for recurrent laryngeal papillomatosis