Recurrent respiratory papillomatosis

RRP is a devastating disease caused by the vertical transmission of HPV types 6, 11, and occasionally 16. Despite extensive investigation, much remains to be understood regarding the precise mechanism of viral transmission, and the risk of disease expression in infants delivered to mothers with cervical HPV infection. Characterized by the relentless growth of papillomatous lesions, RRP induces hoarseness and sometimes life- threatening airway obstruction. The diagnosis of RRP in pediatric patients is often delayed because of its ability to mimic other respiratory disorders. Surgical excision of the papillomata remains the mainstay of therapy, but even when all visible disease is removed, recurrences are the rule. Multiple forms of adjuvant therapy have been advocated to aid in disease control, although none are universally curative. Many patients with RRP enter spontaneous remission, although the age and severity of disease prior to this welcome respite are unpredictable