Tracheotomy in children with recurrent respiratory papillomatosis

✍ Scribed by Randolph R. Cole; Dr. Charles M. Myer III; Robin T. Cotton

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 387 KB
• Volume: 11
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.2880110306

✦ Synopsis

Fifty-eight patients with laryngeal papillomatosis were managed at Children's Hospital Medical Center, Cincinnati, OH, between January 1978 and December 1987. Twelve of these patients (21 Yo) had tracheotomies. A retrospective review of these 12 cases was undertaken to determine the incidence, pattern, timing, and clinical risk factors for tracheal spread after tracheotomy. Six of 12 patients (50%) developed tracheal papillomas after tracheotomy. Peristomal mucosa was consistently the site of initial involvement followed by progressive distal spread along the length of the tracheotomy tube. Stoma1 involvement followed tracheotomy by an average of 14 weeks, occurring as early as 7 weeks postoperatively. Mid-tracheal spread followed stoma1 involvement by an average of 10 weeks. Risk factors for tracheal spread included the presence of subglottic disease at the time of tracheotomy and prolonged cannulation. Whenever possible, tracheotomy should be avoided in patients with recurrent respiratory papillomatosis. When unavoidable, every effort should be made to keep the duration of cannulation as short as possible.

HEAD & NECK 11~226-230,1989

Recurrent respiratory papillomatosis (RRP, recurrent laryngeal papillomatosis or juvenile laryngeal papillomatosis) is a vagarious disease that affects both adults and children. Papillomas