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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Case report
Vocal cord surgery and pharmacological treatment of a patient with HPV and recurrent respiratory papillomatosis
  1. Francesco Galletti1,
  2. Francesco Freni1,
  3. Francesco Gazia1 and
  4. Andrea Gallo2
  1. 1 Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
  2. 2 UOC Otorinolaringoiatria - Polo Pontino, Università degli Studi di Roma La Sapienza Facoltà di Medicina e Odontoiatria, Roma, Italy
  1. Correspondence to Dr Francesco Gazia; ssgazia{at}gmail.com

Abstract

Recurrent respiratory papillomatosis (RRP) is caused by persistent infection of the respiratory epithelium by human papillomavirus (HPV), especially HPV 6 and 11. We present a case of surgically treated RRP. The main purpose of our protocol is to remove the lesions with a non-aggressive surgical technique and prevent recurrences with the use of cidofovir for local infiltrations in multiple sessions. We use low-power energy CO2 laser, directed towards the upper part of the vocal cord, to determine a retraction of the mucosa with consequent coverage of the epithelium of the free edge. The aim of this technique is to treat and stop the formation of synechia of the anterior commissure and the free margin of the vocal cords in the anterior commissure. After 8 years follow-up, there are no signs of recurrence of the disease. The voice had a net improvement confirming the effectiveness of the protocol.

  • ear, nose and throat/otolaryngology
  • drugs: infectious diseases
  • pharmacology and therapeutics

https://doi.org/10.1136/bcr-2019-231117

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    Footnotes

    • Contributors FGal developed the concept and design of the study and treated the patient. FGaz is corresponding author, was preparing the manuscript. FF performed operation of the patient. AG critically revised the manuscript for important intellectual content and gave the final approval of the version to be submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.