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Recurrent Respiratory Papillomatosis

What is recurrent respiratory papillomatosis?

Recurrent respiratory papillomatosis (RRP) is a disease characterized by recurrent wart-like growths on the surface of the vocal cords or tissue around the vocal cords. RRP is caused by specific types of the human papilloma virus (HPV) and is typically benign; however, it tends to recur because the virus persists in the tissue even after the growths are removed.

The location of the papilloma determines what symptoms are experienced: Growths on the vocal cords often cause voice changes, and if the lesions become very large they can cause trouble breathing.

More Information about Recurrent Respiratory Papillomatosis from Johns Hopkins Medicine

Dr. Simon Best conducting RRP research

Laser Surgery Brings Back Patient’s Voice

Jessica noticed that her voice was hoarse and raspy, and having had laryngitis before, she figured the symptoms would fade with time. After they persisted for three weeks, she saw an otolaryngologist (ENT) who diagnosed her with recurrent respiratory papillomatosis (RRP). After 16 surgeries she was still having trouble speaking and it had begun to affect her ability to breathe. Through an RRP Facebook group, she found Simon Best, MD, and decided it was time for another opinion.

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How is recurrent respiratory papillomatosis diagnosed?

Recurrent respiratory papillomatosis can be suspected based on how the vocal cords look on exam. A biopsy is often performed to both confirm the diagnosis of RRP and also to make sure that the lesions show no precancerous changes.

Recurrent Respiratory Papillomatosis Treatment

Treatment of recurrent respiratory papillomatosis centers on careful removal of the lesions without damaging the underlying components of the vocal cords that allow vibration and voice production. Our experts have expertise in treating RRP lesions with lasers, which allows precise removal of the lesions while limiting long-term damage to normal vocal fold tissue. KTP (potassium titanyl phosphate) laser treatments can be performed in-office or in the operating room — the size and location of the lesions will help you and your treatment team to decide which approach is most appropriate for you. Other treatments designed to be used with surgery are available (antiviral or blood vessel-growth limiting medications) and are a subject of ongoing research — your treatment team will discuss whether these additional treatments are appropriate for you.

While surgery treats the symptoms of RRP by removing or reducing the size of the lesions, it does not treat the underlying cause (HPV infection). RRP commonly causes recurrent lesions, so it is important to get frequent examinations and if necessary, undergo multiple surgeries to limit the effects of RRP on the voice box.

Reviewed by Simon Best, M.D., from the Department of Otolaryngology-Head and Neck Surgery.

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