Juvenile papillomatosis is the most common benign laryngeal tumor in children, caused by HPV types 6 and 11. It is thought children contract it from their mothers during birth if the mother had HPV. Papillomas typically affect the supraglottic and glottic regions but can spread lower. Children who had tracheostomies are more likely to have tracheal and stoma involvement due to seeding. Symptoms include hoarseness, difficulty breathing, or stridor in children ages 3-5. Diagnosis is via laryngoscopy and biopsy. Treatment involves laser excision to remove papillomas while preserving the voice, but recurrence is common and requires repeated procedures.

1. Presented by:-
Pranshay Sharma
(90)

2. Juvenile papillomatosis is the most
common benign neoplasm of the
larynx in children.
It is viral in origin and is caused by
human papilloma DNA virus type 6
and 11.
It is presumed that affected children
got the disease at birth from their
mothers who had vaginal human
papilloma virus disease.

3. • Papillomas mostly affect
supraglottic and glottic
regions of larynx but can also
involve subglottis, trachea
and bronchi .
• Children who had
tracheostomy for respiratory
distress due to laryngeal
papillomas have higher
incidence of tracheal and
stomal involvement due to
seeding.
• DNA virus particles have
been found in the cells of
basement membrane of
respiratory mucosa and may
account for widespread
involvement and recurrence.

4. SIGN AND SYMPTOPMS
 Patient, often a child, between the age of 3 and 5 years
presents with hoarseness or aphonia with respiratory
difficulty or even stridor.
 Diagnosis is made by flexible fibreoptic laryngoscopy
and later confirmed by direct laryngoscopy and biopsy.
 Papillomas are known for recurrence but rarely
undergo malignant change.

5. TREATMENT
 Treatment consists of microlaryngoscopy and CO2
laser excision avoiding injury to vocal ligament.
 Recurrence is common and procedure needs to be
repeated several times.
 In the absence of facilities of CO2 laser, tumour can
be removed under microscope with cup forceps or a
debrider similar to the one used in endoscopic nasal
surgery.
 Aim of therapy is to maintain a good airway, preserve
voice and avoid recurrence.

6.  Besides surgery, various medical therapies are being
used an adjuvants.
 Alpha-2a has shown promising results but has several
side effects including fever, chills, myalgia, arthralgia,
headache, loss of weight and suppression of bone
marrow.
 Similarly 13-cis-retinoic acid has been used. This too
has several side effects.