Recurrent Laryngeal Papillomatosis

Recurrent Laryngeal Papillomatosis

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Q. 1

All of the following statements about Recurrent Laryngeal Papillomatosis are true, EXCEPT:

 A

Caused by Human Papilloma Virus (HPV)

 B

HPV6 and HPV11 are most commonly implicated

 C

HPV6 is more virulent than HPV11

 D

Transmission to neonate occurs through contact with mother during vaginal delivery

Q. 1

All of the following statements about Recurrent Laryngeal Papillomatosis are true, EXCEPT:

 A

Caused by Human Papilloma Virus (HPV)

 B

HPV6 and HPV11 are most commonly implicated

 C

HPV6 is more virulent than HPV11

 D

Transmission to neonate occurs through contact with mother during vaginal delivery

Ans. C

Explanation:

HPV 11 related Recurrent respiratory papillomatosis is more aggressive than HPV 6 mediated disease is supported by the clinical evidence.

HPV 11 does demonstrate a greater probability of producing malignant changes also.

 

Q. 2

A girl 14 yrs of age presented in emergency with mild respiratory distress. On laryngoscopy she was diagnosed to have multiple juvenile papillomatosis of the larynx. Next line of management is:

 A

Tracheostomy

 B

CO2 laser resection

 C

Steroid

 D

Antibiotics

Q. 2

A girl 14 yrs of age presented in emergency with mild respiratory distress. On laryngoscopy she was diagnosed to have multiple juvenile papillomatosis of the larynx. Next line of management is:

 A

Tracheostomy

 B

CO2 laser resection

 C

Steroid

 D

Antibiotics

Ans. B

Explanation:

Recurrent respiratory papillomatosis (RRP)  is caused by human papilloma virus (HPV), subtypes 6 and 11.

Papillomas typically appear as multiple, friable, irregular warty growths in the larynx.

These lesions particularly affect the “true” and “false” vocal cords. Patients with glottic lesions present with dysphonia; those with supraglottic lesions may present with stridor.

Treatment include CO2 laser resection, cold steel dissection, or use of the laryngeal microdebrider.

Tracheostomy should be avoided and is associated with distal airway involvement.


Q. 3

Most common manifestation of HPV infection in children –

 A

Single papilloma

 B

Multiple papillomatosis

 C

Osteoma

 D

Sarcoma

Q. 3

Most common manifestation of HPV infection in children –

 A

Single papilloma

 B

Multiple papillomatosis

 C

Osteoma

 D

Sarcoma

Ans. B

Explanation:

Ans. is ‘b’ i.e., Multiple papillomatosis

o Multiple warts are common.


Q. 4

Most common site of laryngeal papilloma in adult is

 A

Anterior commissure

 B

Posterior commissure

 C

Anterior half of vocal cord

 D

a and c

Q. 4

Most common site of laryngeal papilloma in adult is

 A

Anterior commissure

 B

Posterior commissure

 C

Anterior half of vocal cord

 D

a and c

Ans. D

Explanation:

 

Adult onset papilloma usually arise from the anterior half of the vocal cord or anterior commissure.

They are usually single, small in size, less aggressive and do not recur after surgical removal.

M/C in males (2:1), in age group 30-50 year.



Q. 5

Of the following statements about Recurrent Laryngeal papillomatosis are true, Except

 A

Caused by Human Papilloma Virus (HPV)

 B

HPV6 and HPV11 are most commonly implicated

 C

HPV6 is more virulent than HPV11

 D

Transmission to neonate occurs through contact with mother during vaginal delivery

Q. 5

Of the following statements about Recurrent Laryngeal papillomatosis are true, Except

 A

Caused by Human Papilloma Virus (HPV)

 B

HPV6 and HPV11 are most commonly implicated

 C

HPV6 is more virulent than HPV11

 D

Transmission to neonate occurs through contact with mother during vaginal delivery

Ans. C

Explanation:

 

Recurrent Laryngeal Papillomatosis / Recurrent Respiratory Papillomatosis

Etiology

  • Associated with Human Papilloma Virus infection (HPV)
  • HPV6 and HPV 11 are most commonly associated with laryngeal disease whereas HPV 16 and HPV 18 are less commonly associated.
  • HPV11 is associated with a more aggressive disease and makes the patient more prone to malignant change
  • Thus HPV 11 is more virulent

Epidemiology

  • Most commonly occur in children
  • Male female ratio – same (first born vaginally delivered child of a teenage mother is most prone)

Transmission

  • Exact mode of transmission is not known.
  • There is recognized transmission from genital warts.
  • Vertical transmission of virus from mother to child can occur either as ascending uterine infection or through direct contact in birth canal.

 

Malignant transformation in a case of papilloma occurs most commonly in distal bronchopulmonary tree and prognosis is univer­sally poor




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