Dysplasia in Adults With Recurrent Respiratory Papillomatosis: Incidence and Risk Factors

Objectives: Recurrent respiratory papillomatosis (RRP) causes significant morbidity in laryngology. The incidence of dysplasia in adult patients with RRP has not been well described. In this study, the risk factors and incidence of RRP-associated dysplasia are investigated. Methods: Pathology specimens from patients with RRP overa 6-year period are reviewed, along with the patients' clinical and demographic information. Results: Fifty-two male and 21 female patients (mean, 50 years) with RRP were identified. Some degree of dysplasia was identified in 22 of 170 specimens (13%). Sixteen of the 73 patients (21.9%) were found to have dysplasia at some point during their clinical course. Although the patients with RRP-associated dysplasia were older (56.3 versus 48.3 years of a-e), this difference did not reach statistical significance (p < 0.09, unpaired mest). There was a male preponderance in both dysplastic (10 of 16; 62.5%) and non-dysplastic (42 of 57; 73%) cases. The mean number of operations for RRP was 2.4 for patients without dysplasia and 3.2 for those with dysplasia; there was no significant difference between the groups. Seven of the 16 patients with dysplasia (44%) and 22 of the 57 patients without dysplasia (39%) had a history of tobacco use (p < 0.77, Fisher's exact test). Conclusions: Dysplasia was discovered in more than 20% of adult patients with RRP studied over a 6-year period. Age, gender, tobacco history, and operative frequency were not identifiable risk factors for the presence of dysplasia.