Recurrent respiratory papillomatosis: current and future perspectives

Marco Carifi,1 Domenico Napolitano,1 Morando Morandi,1 Danilo Dall’Olio2 1Department of Otolaryngology, Azienda Ospedaliera di Rilievo Nazionale A Cardarelli, Naples, 2Department of Otolaryngology, Ospedale Maggiore CA Pizzardi, Bologna, Italy Abstract: Although recurrent respiratory papillomatosis is a benign disease of the upper aerodigestive tract caused by infection with human papillomavirus, the disease process is unpredictable, ranging from mild disease and spontaneous remission to an aggressive disease with pulmonary spread and requirement for frequent surgical debulking procedures. It can present a protracted clinical course and cause potentially life-threatening compromise of the airways. Over recent decades, a number of alternative medical therapies to standard surgical treatment have been investigated, with modest outcomes overall. Currently, some additional therapies are being explored, together with novel surgical instrumentation that can help to avoid inevitable long-term stenotic complications, ultimately affecting quality of life. Hopefully, clinicians might soon be able to significantly improve the quality of treatment and outcomes for patients affected with recurrent respiratory papillomatosis, with human papillomavirus vaccination having a potentially important role. Keywords: recurrent respiratory papillomatosis, laryngeal papillomatosis, adjuvant, cidofovir, bevacizumab, photodynamic therapy, microdebrider, angiolytic laser, celecoxib, HspE