Objective To describe our experience using laser excision and locally injected
mumps vaccine to induce remission in patients with recurrent respiratory papilloma
(RRP).
Setting Tertiary care regional medical center.
Participants Initially, 11 children with RRP treated in a pilot study with laser
excision at regular intervals for at least a year without adjuvant therapy;
later, a series of 18 children and 20 adults with RRP, some of whom had used
various adjuvant therapy with interval laser excision.
Interventions Both patient groups continued their same interval laser excision with
the same or similar laser, same clinical setting, and same surgeon. Locally
injected mumps vaccine was then administered into the excision site after
each laser removal of papilloma.
Outcome Measures Larynx and trachea were microphotographed with each treatment. Two consecutive
disease-free intervals and a follow-up of at least 1 year were required criteria
for remission.
Results In the pilot study, remission was induced in 9 (82%) of 11 patients
by 1 to 10 injections, with follow-up of 5 to 19 years. In the subsequent
series, remission was induced in 29 (76%) of 38 patients by 4 to 26 injections,
and follow-up was 2 to 5 years.
Conclusions Combined with serial laser excision, mumps vaccine positively influences
induction of remission in children with RRP. The mechanisms of this effect
are unclear, but the treatment is readily available, inexpensive, and has
a low risk of adverse effects.
