Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review
| dc.contributor.advisor | Peer, Shazia | |
| dc.contributor.advisor | Fagan, Johan | |
| dc.contributor.author | Pretorius, Vincent | |
| dc.date.accessioned | 2020-02-06T08:03:46Z | |
| dc.date.available | 2020-02-06T08:03:46Z | |
| dc.date.issued | 2019 | |
| dc.date.updated | 2020-02-04T08:05:59Z | |
| dc.description.abstract | Introduction: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is the commonest benign paediatric neoplasm. There is no curative treatment, but the condition is self-limiting. Current primary treatment is aimed at symptomatic relief, comprising of serial surgical debulking of obstructive papillomas along the respiratory tract, with voice preservation. Adjuvant therapy is indicated in severe cases. Objective: A review of children with JoRRP presenting to the ENT Department at Red Cross War Memorial Children’s Hospital (RCWMCH) over 2 years. Evaluation of the pattern of disease and factors that may contribute to disease severity were reviewed. Method: Retrospective folder review of children with histologically confirmed laryngeal papillomatosis over above the time period. Results: Twenty children were included. Nine were male, 11 were female. The median age at diagnosis was 2.4 years (11 - 109 months). Presentation at < 3 years was noted in 5/7 of the most severe cases. Nine of 20 were HPV serotyped; 5 were type 11, and 4 were type 6. Eighty percent (16/20) were HIV negative; 10% (2/20) HIV positive; and 10% (2/20) were unknown. A total of 90 surgical procedures were performed; the highest number of surgeries per child was 13. Inter-surgical time was 1 to 164 weeks (median 9 weeks). Four received Gardasil vaccination as adjuvant therapy, 3 of who showed a reduction in disease severity. Conclusion: JoRRP commonly presents around the first 3 years of life. Severe cases can be life-threatening, often with multiple hospital admissions for clearance of surgical papillomata. Severe cases presented before 3 years. Gardasil vaccination as adjuvant therapy has promise. No identifiable risk factors in our review were noted. HIV co-infection and HPV type were not risk factors for severity. | |
| dc.identifier.apacitation | Pretorius, V. (2019). <i>Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review</i>. (). ,Faculty of Health Sciences ,Division of Otorhinolaryngology. Retrieved from http://hdl.handle.net/11427/30877 | en_ZA |
| dc.identifier.chicagocitation | Pretorius, Vincent. <i>"Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review."</i> ., ,Faculty of Health Sciences ,Division of Otorhinolaryngology, 2019. http://hdl.handle.net/11427/30877 | en_ZA |
| dc.identifier.citation | Pretorius, V. 2019. Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review. | en_ZA |
| dc.identifier.ris | TY - Thesis / Dissertation AU - Pretorius, Vincent AB - Introduction: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is the commonest benign paediatric neoplasm. There is no curative treatment, but the condition is self-limiting. Current primary treatment is aimed at symptomatic relief, comprising of serial surgical debulking of obstructive papillomas along the respiratory tract, with voice preservation. Adjuvant therapy is indicated in severe cases. Objective: A review of children with JoRRP presenting to the ENT Department at Red Cross War Memorial Children’s Hospital (RCWMCH) over 2 years. Evaluation of the pattern of disease and factors that may contribute to disease severity were reviewed. Method: Retrospective folder review of children with histologically confirmed laryngeal papillomatosis over above the time period. Results: Twenty children were included. Nine were male, 11 were female. The median age at diagnosis was 2.4 years (11 - 109 months). Presentation at < 3 years was noted in 5/7 of the most severe cases. Nine of 20 were HPV serotyped; 5 were type 11, and 4 were type 6. Eighty percent (16/20) were HIV negative; 10% (2/20) HIV positive; and 10% (2/20) were unknown. A total of 90 surgical procedures were performed; the highest number of surgeries per child was 13. Inter-surgical time was 1 to 164 weeks (median 9 weeks). Four received Gardasil vaccination as adjuvant therapy, 3 of who showed a reduction in disease severity. Conclusion: JoRRP commonly presents around the first 3 years of life. Severe cases can be life-threatening, often with multiple hospital admissions for clearance of surgical papillomata. Severe cases presented before 3 years. Gardasil vaccination as adjuvant therapy has promise. No identifiable risk factors in our review were noted. HIV co-infection and HPV type were not risk factors for severity. DA - 2019 DB - OpenUCT DP - University of Cape Town KW - HPV KW - papillomatosis KW - JoRRP KW - RRP KW - stridor KW - hoarseness KW - Upper Airway Obstruction (UAO) KW - Gardasil KW - paed LK - https://open.uct.ac.za PY - 2019 T1 - Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review TI - Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review UR - http://hdl.handle.net/11427/30877 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/30877 | |
| dc.identifier.vancouvercitation | Pretorius V. Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review. []. ,Faculty of Health Sciences ,Division of Otorhinolaryngology, 2019 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/30877 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Division of Otorhinolaryngology | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | HPV | |
| dc.subject | papillomatosis | |
| dc.subject | JoRRP | |
| dc.subject | RRP | |
| dc.subject | stridor | |
| dc.subject | hoarseness | |
| dc.subject | Upper Airway Obstruction (UAO) | |
| dc.subject | Gardasil | |
| dc.subject | paed | |
| dc.title | Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) at Red Cross War Memorial Children’s Hospital, Cape Town: A 2-year review | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationname | MMed |