Laryngeal papillomatosis in a 3 year old infant: surgical and anesthesiological management

Juvenile-Onset recurrent respiratory papillomatosis (JO-RRP) is the most frequent benign neoplasm in children with tendency to recur. Human Papilloma Virus (HPV) types 6 and 11 are involved in its etiology. Maternal transmission during the passage through the birth canal is the most frequent modality of infection. Clinical mani-festations of JO-RRP may include dysphonia, dysphagia, hoarseness, cough and, in the most severe cases, respira -tory distress. We report a case of a 3-year-old infant with a history of hoarseness and persistent dysphonia. Laryn-goscopy showed diffuse papillomatous warts involving the glottic space and the false vocal cords. An accurate preoperative anesthesiological evaluation was provided. Surgical intervention in microlaryngos-copy was performed under general anaesthesia. Removal of the papillomatous warty growths in micro-laryngoscopy was achieved, with significant improve-ment of the glottic space. No intraoperative or postoper-ative complications occurred, the patient resumed per os Castellana et al. Laryngeal papillomatosis in pediatric patient feeding on the same day and was discharged the second postoperative day. At the follow up visit at 1-month, im-portant improvement of the voice quality was evident; laryngoscopy showed the absence of pathology; a strict follow up was planned in order to detect any recurrences.