Juvenile laryngeal papillomatosis in a pediatric population: a clinicopathologic study.

A series of 22 children with juvenile laryngeal papillomatosis treated over a 31-year period is presented. The majority of patients were diagnosed when less than 5 years of age. Two patients died from the disease and four patients still had active disease at the completion of the study period. The duration of disease and number of recurrences were extremely variable. The number of recurrences was inversely related to the age of onset. The histologic findings were very similar in all patients, and no particular histologic feature had prognostic significance. In 20 patients, laryngeal biopsies were positive for human papillomavirus (HPV) 6/11 by either in situ hybridization (17) or polymerase chain reaction (19) or both (16). The number of patients who were HPV negative was small (two); interestingly, neither case had aggressive disease. Our findings suggest that age of onset and HPV status may be of prognostic value in determining the clinical course of the disease.