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A Preliminary Report

Craig S. Derkay, MD

Arch Otolaryngol Head Neck Surg. 1995;121(12):1386-1391.

Abstract
Objective
To obtain pilot data about the incidence, need for surgical intervention, and demographics of recurrent respiratory papillomas in the United States.

Design
Otolaryngologists were surveyed using a questionnaire with structured and open-ended questions.

Participants
One thousand board-certified otolaryngologists practicing in the United States as of January 1, 1993, through a random mailing list provided by the American Academy of Otolaryngology—Head and Neck Surgery and all active US members of the American Society of Pediatric Otolaryngology and the American Bronchoesophagological Association. A total of 1346 questionnaires were distributed.

Main Outcome Measures
Physician's responses to questions about their current patient load of children and adults with recurrent respiratory papillomas, their surgical and anesthetic management of the disease, and their clinical experiences with risk factors for developing recurrent respiratory papillomas.

Results
Projected totals for recurrent respiratory papillomas among children were 2354 new cases (95% confidence interval [CI], 1448 to 3260) and 5970 active cases (95% CI, 3465 to 8474), requiring 16 597 surgical procedures (95% CI, 6938 to 26 255) at a cost of $109 million (95% CI, $45 to $172 million) for March 1, 1993 to March 31, 1994. Projected totals for adult recurrent respiratory papillomas were 3623 new cases (95% CI, 2359 to 4887) and 9015 active cases (95% CI, 6435 to 11 591) requiring 9284 surgical procedures (95% CI, 6003 to 12 565) at a cost of $42 million (95% CI, $27 to $59 million) for March 1, 1993 to March 31, 1994. The incidence of recurrent respiratory papillomas among children is estimated at 4.3 per 100 000; among adults, 1.8 per 100 000. The carbon dioxide laser was favored by 92% of respondents. No consensus was reached on the role for cesarean section. Forty-six percent of respondents favored the use of a laser-safe endotracheal tube for anesthetic management.

Conclusion
A registry of patients with recurrent respiratory papillomas would benefit future research protocols and provide long-term follow-up of patients.

(Arch Otolaryngol Head Neck Surg. 1995;121:1386-1391)

Author Affiliations
From the Department of Otolaryngology—Head and Neck Surgery, Eastern Virginia Medical School, Norfolk.

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