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BCM - Baylor College of Medicine

Giving life to possible

Otolaryngology - Head and Neck Surgery

Recurrent Respiratory Papillomatosis

What Is Recurrent Respiratory Papillomatosis (RRP)?

RRP is a disease in which wart-like lesions grow in the voice box.

What Causes RRP?

RRP is associated with the human papillomavirus (HPV). There are several different serotypes (also known as subtypes) of this virus. Serotypes 6 and 11 are most commonly associated with RRP.

Wait, Doesn't HPV Cause Cervical Cancer?

There are several different serotypes (also known as subtypes) of HPV. Serotypes 16 and 18 are associated with cervical cancer, while 6 and 11 are associated with RRP.

What Are the Symptoms of RRP?

In adults, RRP can cause a change of voice and, rarely, difficulty breathing. It is more common for children who have RRP to present with noisy breathing and shortness of breath.

How Do You Treat RRP?

The mainstay of treatment is surgical removal of the papillomas (warts) in the operating room. This can be cone in several different ways. Some surgeons use lasers, others use cold knife, and others may use an instrument called a microdebrider. There are a multitude of additional (or adjuvant) therapies for RRP. The data remains mixed regarding their effectiveness.

Why Is the Word "Recurrent" in the Disease Name?

As implied by the name, RRP has a tendency to come back after surgical removal. How long it takes for the disease to recur is extremely variable between individuals and even within individuals. There are individuals who can go through exacerbations of disease, requiring multiple surgeries within a year, followed by a period of fewer surgeries. The causes of these "flare ups" is not yet well understood.

Will My Voice Ever Be Like It Was Before I Had RRP?

The goal of all RRP treatment is to remove disease while restoring and preserving voice. That being said, in all cases there can be some scar tissue as a result of the removal of the papilloma. This can cause slight changes in voice.