Impact of surgical treatment on the laryngeal presentation of recurrent respiratory papillomatosis

Abstract

Introduction: Recurrent respiratory papillomatosis is characterized by the formation of benign neoplasms in the upper airway, predominantly in the larynx. The treatment is surgical, focused on resecting lesions and preserving respiratory and vocal function, with adjuvant therapy in severe cases. Objective: To identify clinical, epidemiological, and the- rapeutic characteristics in patients with laryngeal papillomatosis, and to evaluate surgi- cal outcomes. Methods: Retrospective study of patients diagnosed with laryngeal papillo- matosis at the Voice Unit of the UC-Christus Health Network between 2019 and 2024. Results: Forty-three patients were included, with an average age of 42.5 ± 16.1 years and male predominance (3:1). The most common symptoms were dysphonia (100%), throat clearing (16%), and dyspnea (14%). The left and right vocal folds were affected in 81% and 76% of cases, respectively. The average VHI-10 score and Derkay scale at diagnosis were 22.5 ± 12 and 4.7 ± 3 points, respectively. All patients had surgical indication, with 23 having undergone at least one surgery at our center. HPV 6 was identified in 85% of the analyzed cases. A total of 47 surgeries were performed, with 84.4% using a microdebrider, achieving a significant reduction in VHI-10 scores (from 22.3 to 8.7; p = 0.03) and Derkay scores (from 5.1 to 1.2; p < 0.0001). Conclusions: Laryngeal papillomatosis predominantly affected adult males, with a predominance of HPV 6. Dysphonia was the main symptom, and surgery showed a significant reduction in vocal impairment and lesion burden.