Dysphonia in the child

Introduction Juvenile papillomatosis of the larynx is a rare benign juvenile neoplasia oft he larynx and is caused by low-risk human Papilloma viruses (HPV). The transmission occurs propably via the birth canal due to maternal cervical HPV-infection. Symptoms range from dysphonia und stridor to acute dyspnea. Therapy consists of the removal of the papilloma by laser surgery or microsurgery or anti-viral drugs. Ultima ratio is a tracheostomy Juvenile papillomatosis of the larynx has a high recurrence rate and a small risk of malignant transformation. Usually, it heals at the age of puberty.

Case report A girl with a diagnosed juvenile papillomatosis of the larynx at the age of 2 had already neaded multiple removals of the papilloma by laser surgery or microsurgery, a systemic long-term-therapy with aciclovir, topic therapeutic procedures, a HPV-immunisation and at the age of 7, a tracheostomy in a case of emergency. In May 2021, large masses of papilloma was detected in the trachea with only small airway lumen left. A systemic therapy with bevacizumab (avastin) as off-lable therapy was initiated.

Results Already after the first application of avastin the papilloma in the trachea were strongly reduced. After three therapy cycles a reductions of the papilloma of more than 50% could be detected. No side effects were observed.

Conclusion Juvenile papillomatosis of the larynx is a rare disease which is difficult to treat. In severe cases, when other therapies are ineffective avastin can be a useful therapy. To date, results are promising.

Publication History

Article published online:
13 June 2022