What causes Recurrent Respiratory Papillomatosis?
RRP is a disease process in which benign (noncancerous) tumors called papillomas grow in the respiratory tract. The papillomas grow primarily in the larynx and trachea, and therefore commonly present with voice changes or difficulty breathing. RRP is caused by the Human Papillomavirus (HPV types 6 and 11). Most people who encounter HPV never develop a related illness. However, in a small number of people exposed the virus, papillomas form recurrently. Scientists do not fully understand why some people develop the disease and others do not. Patients with RRP require recurrent treatments of the papillomas at variable intervals depending on the severity of their disease. There are both juvenile and adult onset forms of the disease.
What are symptoms of Recurrent Respiratory Papillmatosis?
- Hoarseness
- Shortness of air
- Noisy Breathing
- Increased vocal effort
- Feeling of foreign body in throat
What is the treatment for Recurrent Respiratory Papillomatosis?
The treatment for RRP with Dr. Burckardt includes initial management in the operating room with KTP laser ablation of the papilloma and a vocal cord injection of Avastin (Bevacizumab). The KTP laser targets the blood vessels that feed the papillomas, while preserving normal vocal cord tissue. Avastin is a safe drug injected directly into the vocal folds that has been proven to prolong the intervals between RRP regrowth. The procedure is performed under general anesthesia and is an outpatient surgery.
After initial management in the operating room, RRP can be managed without the need for general anesthesia with awake laser surgery. Recurrent papillomas can be treated with the KTP laser and topical anesthesia (numbing spray) in a procedure room. The procedure is comfortable enough that sedation is not needed. You can drive yourself to and from the procedure and it is completed in under 30 minutes. Avastin injection can also be performed during the procedure.
For information, regarding awake laser surgery, please visit our FAQ page.
References: Best et al., Safety and Dosing of Bevacizumab (avastin) for the treatment of recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol. 2012 Sep;121(9):587-93. doi: 10.1177/000348941212100905.
Zeitels, et al., Local injection of Bevacizumavb (Avastin) and Angiolytic KTP Laser Treatment of Recurrent Respiratory Papillmatosis of the Vocal Folds: A Prospective Study. Ann Otol Rhinol Laryngol. 2011 Oct;120(10):627-34. doi: 10.1177/000348941112001001.
After initial management in the operating room, RRP can be managed without the need for general anesthesia with awake laser surgery. Recurrent papillomas can be treated with the KTP laser and topical anesthesia (numbing spray) in a procedure room. The procedure is comfortable enough that sedation is not needed. You can drive yourself to and from the procedure and it is completed in under 30 minutes. Avastin injection can also be performed during the procedure.
For information, regarding awake laser surgery, please visit our FAQ page.
References: Best et al., Safety and Dosing of Bevacizumab (avastin) for the treatment of recurrent respiratory papillomatosis. Ann Otol Rhinol Laryngol. 2012 Sep;121(9):587-93. doi: 10.1177/000348941212100905.
Zeitels, et al., Local injection of Bevacizumavb (Avastin) and Angiolytic KTP Laser Treatment of Recurrent Respiratory Papillmatosis of the Vocal Folds: A Prospective Study. Ann Otol Rhinol Laryngol. 2011 Oct;120(10):627-34. doi: 10.1177/000348941112001001.