Nigel R T Pashley1. 1. Presbytarian/St Luke's Hospital, Denver, CO, USA. npashley@aol.com
Abstract
OBJECTIVE: To describe our experience using laser excision and locally injected mumps vaccine to induce remission in patients with recurrent respiratory papilloma (RRP). SETTING: Tertiary care regional medical center. PARTICIPANTS: Initially, 11 children with RRP treated in a pilot study with laser excision at regular intervals for at least a year without adjuvant therapy; later, a series of 18 children and 20 adults with RRP, some of whom had used various adjuvant therapy with interval laser excision. INTERVENTIONS: Both patient groups continued their same interval laser excision with the same or similar laser, same clinical setting, and same surgeon. Locally injected mumps vaccine was then administered into the excision site after each laser removal of papilloma. OUTCOME MEASURES: Larynx and trachea were microphotographed with each treatment. Two consecutive disease-free intervals and a follow-up of at least 1 year were required criteria for remission. RESULTS: In the pilot study, remission was induced in 9 (82%) of 11 patients by 1 to 10 injections, with follow-up of 5 to 19 years. In the subsequent series, remission was induced in 29 (76%) of 38 patients by 4 to 26 injections, and follow-up was 2 to 5 years. CONCLUSIONS: Combined with serial laser excision, mumps vaccine positively influences induction of remission in children with RRP. The mechanisms of this effect are unclear, but the treatment is readily available, inexpensive, and has a low risk of adverse effects.
OBJECTIVE: To describe our experience using laser excision and locally injected mumps vaccine to induce remission in patients with recurrent respiratory papilloma (RRP). SETTING: Tertiary care regional medical center. PARTICIPANTS: Initially, 11 children with RRP treated in a pilot study with laser excision at regular intervals for at least a year without adjuvant therapy; later, a series of 18 children and 20 adults with RRP, some of whom had used various adjuvant therapy with interval laser excision. INTERVENTIONS: Both patient groups continued their same interval laser excision with the same or similar laser, same clinical setting, and same surgeon. Locally injected mumps vaccine was then administered into the excision site after each laser removal of papilloma. OUTCOME MEASURES: Larynx and trachea were microphotographed with each treatment. Two consecutive disease-free intervals and a follow-up of at least 1 year were required criteria for remission. RESULTS: In the pilot study, remission was induced in 9 (82%) of 11 patients by 1 to 10 injections, with follow-up of 5 to 19 years. In the subsequent series, remission was induced in 29 (76%) of 38 patients by 4 to 26 injections, and follow-up was 2 to 5 years. CONCLUSIONS: Combined with serial laser excision, mumps vaccine positively influences induction of remission in children with RRP. The mechanisms of this effect are unclear, but the treatment is readily available, inexpensive, and has a low risk of adverse effects.
Authors: Kevin Motz; Idris Samad; Linda X Yin; Michael K Murphy; Madhavi Duvvuri; Dacheng Ding; Alexander T Hillel Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-11-01 Impact factor: 6.223
Authors: N Mansi; V de Maio; A della Volpe; G Ripa; L Malafronte; C de Filippis Journal: Int J Pediatr Otorhinolaryngol Date: 2009-12 Impact factor: 1.675