Pediatric Laryngeal Papillomas

Pediatric Laryngeal Papillomas

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Summary

Laryngeal papillomas are small, wart-like, growths that develop on the larynx and vocal cords. They can affect the normal function of the vocal cords and lead to breathing difficulties.

Expanded Overview

Laryngeal papillomas (also known as recurrent respiratory papillomatosis) form in varying sizes and develop within the respiratory tract, most often affecting the larynx (voice box). When the vocal cords (also called vocal folds) become covered with these fast-producing nodules, they do not vibrate effectively to produce sound. As a result, your child’s voice is hoarse and weak. 

As papillomas spread in the respiratory tract, they can grow on the trachea (windpipe), bronchi and occasionally, the lungs. When papillomas obstruct the airway, they can cause breathing difficulties.

Laryngeal papillomas are benign (noncancerous) growths in the vast majority of cases. In rare cases — less than 1 percent — they can become cancerous. Papillomas can be stubborn when removed and often grow back.

Laryngeal papillomas are usually diagnosed by the age of 12 and can go into remission (disappear) when a child hits puberty (between the ages of 10 and 14 for girls and between the ages of 12 and 16 for boys*).

Causes

Human papillomavirus (HPV) causes laryngeal papillomas. In most cases, it’s transmitted to children as they pass through the birth canal of their mother with HPV. Some cases develop before birth. 

Risk Factors

Children are most at risk for laryngeal papillomas if they are: 

  • The firstborn child
  • Delivered vaginally 
  • Born when their mother is under age 20 

Symptoms

Infants (birth to 1 year**): 

Symptoms of laryngeal papillomas in infants include:

  • Choking
  • Failure to grow and gain weight (failure to thrive)
  • Weak cry

Children age 1 year and older: 

The most common symptom in children is hoarseness. Symptoms can also include: 

  • Choking
  • Chronic cough
  • Difficult and noisy breathing  
  • Difficulty swallowing 
  • Feeling like a foreign body is stuck in the throat 
  • Loss of voice 
  • Shortness of breath 
  • Trouble speaking 
  • Voice that's weak, strained, breathy or low pitched

*Age of puberty is middle childhood to teenage years as defined by the Center for Disease Control (CDC).
**Age of infants as defined by the World Health Organization (WHO)

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