[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Kashima  HMounts  PLeventhal  BHruban  RH Sites of predilection in recurrent respiratory papillomatosis.  Ann Otol Rhinol Laryngol.1993;102:580-583.PubMedGoogle Scholar
Gissmann  LDiehl  VSchultz-Coulon  HJzur Hausen  H Molecular cloning and characterization of human papilloma virus DNA derived from a laryngeal papilloma.  J Virol.1982;44:393-400.PubMedGoogle Scholar
Mounts  PShah  KVKashima  H Viral etiology of juvenile- and adult-onset squamous papilloma of the larynx.  Proc Natl Acad Sci U S A.1982;79:5425-5429.PubMedGoogle Scholar
Armstrong  LRPreston  EJReichert  M  et al Incidence and prevalence of recurrent RP among children in Atlanta and Seattle.  Clin Infect Dis.2000;31:107-109.PubMedGoogle Scholar
Balazic  JMasera  APoljak  M Sudden death caused by laryngeal papillomatosis.  Acta Otolaryngol Suppl.1997;527:111-113.PubMedGoogle Scholar
Peñaloza-Plascencia  MMontoya-Fuentes  HFlores-Martinez  SEFierro-Velasco  FJPeñaloza-González  JMSánchez-Corona  J Molecular identification of 7 human papillomavirus types in recurrent respiratory papillomatosis.  Arch Otolaryngol Head Neck Surg.2000;126:1119-1123.PubMedGoogle Scholar
Armstrong  LRDerkay  CSReeves  WC Initial results from the national registry for juvenile-onset recurrent respiratory papillomatosis.  Arch Otolaryngol Head Neck Surg.1999;125:743-748.PubMedGoogle Scholar
Rimell  FLShoemaker  DLPou  AMJordan  JAPost  JCEhrlich  GD Pediatric respiratory papillomatosis: prognostic role of viral typing and cofactors.  Laryngoscope.1997;107:915-918.PubMedGoogle Scholar
Gabbott  MCossart  YEKan  AKonopka  MChan  RRose  BR Human papillomavirus and host variables as predictors of clinical course in patients with juvenile-onset recurrent respiratory papillomatosis.  J Clin Microbiol.1997;35:3098-3103.PubMedGoogle Scholar
Doyle  DJGianoli  GJEspinola  TMiller  RH Recurrent respiratory papillomatosis: juvenile versus adult forms.  Laryngoscope.1994;104:523-527.PubMedGoogle Scholar
Hartley  CHamilton  JBirzgalis  ARFarrington  WT Recurrent respiratory papillomatosis—the Manchester experience, 1974-1992.  J Laryngol Otol.1994;108:226-229.PubMedGoogle Scholar
Padayachee  APrescott  CA Relationship between the clinical course and HPV typing of recurrent laryngeal papillomatosis: the Red Cross War Memorial Children's Hospital experience 1982-1988.  Int J Pediatr Otorhinolaryngol.1993;26:141-147.PubMedGoogle Scholar
Lindeberg  HElbrond  O Laryngeal papillomas: clinical aspects in a series of 231 patients.  Clin Otolaryngol.1989;14:333-342.PubMedGoogle Scholar
Lindeberg  HSyrjanen  SKarja  JSyrjanen  K Human papillomavirus type 11 DNA in squamous cell carcinomas and pre-existing multiple laryngeal papillomas.  Acta Otolaryngol (Stockh).1989;107:141-149.PubMedGoogle Scholar
Mounts  PKashima  H Association of human papillomavirus subtype and clinical course in respiratory papillomatosis.  Laryngoscope.1984;94:28-33.PubMedGoogle Scholar
Silverberg  MJThorsen  PLindeberg  HGrant  LAShah  KV Condyloma in pregnancy is strongly predictive of juvenile onset recurrent respiratory papillomatosis.  Obstet Gynecol.2003;101:645-652.PubMedGoogle Scholar
Knudsen  LBOlsen  J The Danish Medical Birth Registry.  Dan Med Bull.1998;45:320-323.PubMedGoogle Scholar
Andersen  TFMadsen  MJorgensen  JMellemkjoer  LOlsen  JH The Danish National Hospital Register: a valuable source of data for modern health sciences.  Dan Med Bull.1999;46:263-268.PubMedGoogle Scholar
Cox  DROates  D Analysis of Survival Data.  New York, NY: Chapman & Hall; 1984.
Bomholt  A Juvenile laryngeal papillomatosis: an epidemiological study from the Copenhagen region.  Acta Otolaryngol (Stockh).1988;105:367-371.PubMedGoogle Scholar
Abramson  ALSteinberg  BMWinkler  B Laryngeal papillomatosis: clinical, histopathologic and molecular studies.  Laryngoscope.1987;97:678-685.PubMedGoogle Scholar
Ho  GYBierman  RBeardsley  LChang  CJBurk  RD Natural history of cervicovaginal papillomavirus infection in young women.  N Engl J Med.1998;338:423-428.PubMedGoogle Scholar
Brown  DRSchroeder  JMBryan  JTStoler  MHFife  KH Detection of multiple human papillomavirus types in condylomata acuminata lesions from otherwise healthy and immunosuppressed patients.  J Clin Microbiol.1999;37:3316-3322.PubMedGoogle Scholar
Greer  CEWheeler  CMLadner  MB  et al Human papillomavirus (HPV) type distribution and serological response to HPV type 6 virus-like particles in patients with genital warts.  J Clin Microbiol.1995;33:2058-2063.PubMedGoogle Scholar
Coleman  NBirley  HDRenton  AM  et al Immunological events in regressing genital warts.  Am J Clin Pathol.1994;102:768-774.PubMedGoogle Scholar
Kashima  HLeventhal  BClark  K  et al Interferon alfa-n1 (Wellferon) in juvenile onset recurrent respiratory papillomatosis: results of a randomized study in twelve collaborative institutions.  Laryngoscope.1988;98:334-340.PubMedGoogle Scholar
Somers  GRTabrizi  SNBorg  AJGarland  SMChow  CW Juvenile laryngeal papillomatosis in a pediatric population: a clinicopathologic study.  Pediatr Pathol Lab Med.1997;17:53-64.PubMedGoogle Scholar
Original Article
June 2004

Clinical Course of Recurrent Respiratory Papillomatosis in Danish Children

Author Affiliations

From the Departments of Epidemiology (Drs Silverberg and Ahdieh-Grant) and Molecular Microbiology and Immunology (Dr Shah), Johns Hopkins University, Baltimore, Md (Dr Shah); Epidemiology and Social Medicine, Aarhus University (Dr Thorsen), and the Oral Pathology Laboratory, Royal Dental College (Dr Lindeberg), Aarhus, Denmark. The authors have no relevant financial interest in this article.

Arch Otolaryngol Head Neck Surg. 2004;130(6):711-716. doi:10.1001/archotol.130.6.711

Objective  To evaluate the clinical course of juvenile-onset recurrent respiratory papillomatosis (RP) with respect to age, disease duration, and maternal condylomas.

Design  Inception cohort study.

Setting  All ear, nose, and throat departments in public Danish hospitals.

Patients  Fifty-seven Danish children diagnosed with RP and born between 1974 and 1993 were observed for an average of 14 years after diagnosis.

Main Outcome Measure  Removal of respiratory papillomas by knife biopsy, laser surgery, or cryotherapy.

Results  Children younger than 5 years diagnosed with RP underwent an average of 4.1 surgeries in the first year of disease, the highest rate among all our patients. The overall surgery rate decreased over time after initial di-agnosis but remained significantly higher for children with a younger age of onset for the first 4 years of disease (P <.001) and for children with a maternal history of condylomas in pregnancy for years 4 to 10 of the disease (P <.001). We also observed an independent and statistically significant (P <.001) decreasing surgery rate with increasing age and time from initial diagnosis. The trend for children with recurrent disease was a decreasing rate of surgical procedures (28 of 42 patients with recurrent disease); however, a third of patients (14/42) demonstrated a constant or increasing rate of surgical procedures over time.

Conclusions  The clinical course of RP is characterized by a high frequency of surgeries soon after diagnosis that diminishes over time and with increasing age. Additional studies are warranted to identify factors associated with cases that do not conform to the usual disease course.