The course of laryngeal papillomatosis treated by endolaryngeal microsurgery.

Surgical excision of papillomas remains the mainstay of the management of laryngeal papillomatosis, as causal therapy is not yet available. Eighty-nine patients -32 with juvenile papillomatosis (JP) and 57 with adult papillomas (AP)-- underwent endolaryngeal microsurgery (EM) in our department during the last 15 years. The ENT-department in Kaunas serves most of the patients with laryngeal papilloma among the 3.85 million inhabitants of Lithuania. Therapeutic outcome was assessed as both the recurrence rate and the length of time between recurrences of papillomas in the follow-up period lasting at least 2 years. The recurrence rate was 71.9% (23 patients) in the JP group and 22.8% (13 patients) in the AP group. The interval between recurrences of papillomas ranged from 1 month to 10 years (mean 1.9 years) in the JP group and from 6 months to 9 years (mean 3.2 years) in the AP group. The number of EMs per patient ranged from 1 to 18 (mean 3.2) in the JP group and from 1 to 5 (mean 1.35) in the AP group. EM is a minimally invasive and safe technique which provides accurate removal of papillomas, although recurrence is often unavoidable. Prognosis for the disease therefore remains rather unpredictable.