Recurrent respiratory papillomatosis

by Soham Roy, MD and Richard J. Vivero, MD | Tuesday, January 01, 2008

A 13-year-old girl was referred by a speech therapist for evaluation of hoarseness. She had lived in Jamaica until 1 year before. Her voice had been severely hoarse since infancy, and she had been essentially aphonic since age 2. The patient failed to improve with prolonged speech therapy. She had been seen previously by numerous otolaryngologists and given a diagnosis ranging from vocal fold nodules to vocal fold polyps (figure 1). Physical examination revealed an aphonic, whispering voice with no evidence of respiratory compromise.Flexible nasopharyngoscopy (from an outside institution) shows vocal fold lesionsMicrolaryngoscopy and bronchoscopy revealed an exophytic, sessile lesion extending from the anterior commissure to the posterior third of the left vocal fold (figure 2, A) and a nodular lesion on the right vocal fold. The left vocal fold lesion was biopsied, then removed (figure 2, B) with a microdebrider and cold instrumentation. After surgery, the child was able to speak .../continued/

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