Dr. T. Balasubramanian M.S.
Papilloma larynx are glistening whitish irregular mass
seen in the larynx. It involves the vocal cords, false cords, and
epiglottis. These masses are friable and bleed on touch.
It occurs in two forms : 1. Juvenile papilloma and 2.
Juvenile papilloma : Occurs in infants and young
children. It is multiple, and show aggressive behaviour. These
lesions are known to recur even after successful surgery. It is
caused by Human papilloma virus type 6 or type 1. The affected
children are known to get their infection from infected mother's
genitals during delivery.
These lesions appear as multiple white glistening
irregular, friable masses over the true / false vocal cords. It can
also involve epiglottis. These lesions have a prediliction to
involve the squaocolumnar junction. They show a
very aggressive behaviour. Reccurrence even after successful
surgical removal is common.
The affected patients have hoarseness of voice. The child
may have difficulty especially while crying. If the mass reaches a
size large enough to obstruct the laryngeal inlet, patients develop
Adult papilloma: Is solitary in nature, known to involve
the true vocal cord at the junction of the anterior 1/3 and
posterior 2/3. This is the mobile portion of the vocal cord. Males
are affected twice as common as females. These lesions are not
aggressive and hence surgical management is always
Tracheostomy: to secure the airway if the patient
manifests with stridor.
Microlaryngeal excision of the masses - Bleeding and
airway complications are common during this procedure.
Cryosurgery - Bleeding is minimised during this
Laser surgery - Is best suited for juvenile papillomas.
In this procedure the bleeding is minimal, and scarring is also
Recurrence - In juvenile papilloma can be reduced by
postoperative treatment with interferon. Herbal drung (TUJA) has
been tried with varying degrees of success.
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