Natural progression of dysplasia in adult recurrent respiratory papillomatosis

Joseph E. Hall, Karen Chen, Mi Jin Yoo, Kenneth C. Fletcher, Robert H. Ossoff, C. Gaelyn Garrett

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objectives. Recurrent respiratory papillomatosis (RRP) is often described as a benign disease. However, the natural progression of dysplasia and transformation to squamous cell carcinoma has not been elucidated for RRP. This study delineates our extensive experience with dysplasia in RRP. Study Design/Setting. Case series with chart review. Subjects and Methods. Demographic data and surgical pathology were analyzed for patients diagnosed with RRP at greater than 18 years of age who underwent operative intervention without cidofovir treatment for RRP between 2004 and 2009. Results. Fifty-four patients were identified. Dysplasia was identified in 27 of 54 patients (50%). Of the 54 patients, 50% had no dysplasia, 26% had mild dysplasia (grade 1), 11% had moderate dysplasia (grade 2), 4% had severe dysplasia (grade 3), 7% had carcinoma in situ, and 2% had squamous cell carcinoma as the highest documented degree of dysplasia. Thirty of 54 patients (55.6%) had 2 or more operative interventions. Nine of the 30 patients (30%) developed a higher dysplastic grade during the course of treatment. Time to progression averaged 16.2 ± 8.7 months for patients with initially benign disease. Of those patients with dysplasia progression, only 1 of 9 (11.1%) developed squamous cell carcinoma. Patients presenting with benign or mild dysplasia typically did not progress beyond mild dysplasia (22 of 24, 91.7%). Conclusions. Dysplasia is common in RRP. Progression of dysplasia, especially with an initial dysplastic grading of benign or mild disease, is rare.

Original languageEnglish (US)
Pages (from-to)252-256
Number of pages5
JournalOtolaryngology - Head and Neck Surgery
Issue number2
StatePublished - Feb 2011
Externally publishedYes


  • Dysplasia
  • HPV
  • Natural progression
  • Progression
  • RRP

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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