TY - JOUR
T1 - Prospective, Multi-Center Study of the Anatomic Distribution of Recurrent Respiratory Papillomatosis
AU - Benedict, Peter A.
AU - Kravietz, Adam
AU - Achlatis, Efstratios
AU - Wang, Binhuan
AU - Zhang, Yan
AU - Kidane, Joseph
AU - Harrison, Tina
AU - Miller, Jonas
AU - Drake, Virginia E.
AU - Best, Simon R.
AU - McWhorter, Andrew J.
AU - Lin, R. Jun
AU - Rosen, Clark A.
AU - Smith, Libby J.
AU - Amin, Milan R.
N1 - Publisher Copyright:
© 2022 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2022/12
Y1 - 2022/12
N2 - Objectives/Hypothesis: To create a model of the anatomic distribution, recurrence, and growth patterns of recurrent respiratory papillomatosis (RRP). Study Design: Prospective, multi-institutional cohort study. Methods: Adult patients with a diagnosis of RRP evaluated between August 1, 2018 and February 1, 2021 at six participating centers were invited to enroll. At each office or operating room encounter, laryngologists recorded the location and size of RRP lesions using a 22-region schematic. A generalized linear mixed effects model was used to compare region variations in lesion prevalence and recurrence. Results: The cohort comprised 121 patients: 74% were male, 81% had been diagnosed with adult-onset RRP, and a plurality (34%) had undergone 0 to 3 RRP interventions prior to enrollment. Across the study period, the odds of a lesion occurring in the glottis was significantly higher (odds ratio [OR]: 26.51; 95% confidence interval [CI]: 11.76–59.75, P <.001) compared with all other areas of the larynx and trachea. Within the true vocal folds, the membranous vocal folds had significantly higher odds (OR: 6.16; 95% CI: 2.66–14.30, P <.001) of lesion occurrence compared to the cartilaginous vocal folds. Despite these strong trends in lesion distribution, there were no differences in the odds of lesion recurrence, growth, or in the time to recurrence, between anatomic subsites. Conclusions: RRP lesions are most likely to occur in the glottis, particularly the membranous vocal folds, compared with other regions of the larynx or trachea. However, all lesions demonstrate similar behavior with respect to recurrence, growth, and time to recurrence regardless of anatomic location. Level of Evidence: 3 Laryngoscope, 132:2403–2411, 2022.
AB - Objectives/Hypothesis: To create a model of the anatomic distribution, recurrence, and growth patterns of recurrent respiratory papillomatosis (RRP). Study Design: Prospective, multi-institutional cohort study. Methods: Adult patients with a diagnosis of RRP evaluated between August 1, 2018 and February 1, 2021 at six participating centers were invited to enroll. At each office or operating room encounter, laryngologists recorded the location and size of RRP lesions using a 22-region schematic. A generalized linear mixed effects model was used to compare region variations in lesion prevalence and recurrence. Results: The cohort comprised 121 patients: 74% were male, 81% had been diagnosed with adult-onset RRP, and a plurality (34%) had undergone 0 to 3 RRP interventions prior to enrollment. Across the study period, the odds of a lesion occurring in the glottis was significantly higher (odds ratio [OR]: 26.51; 95% confidence interval [CI]: 11.76–59.75, P <.001) compared with all other areas of the larynx and trachea. Within the true vocal folds, the membranous vocal folds had significantly higher odds (OR: 6.16; 95% CI: 2.66–14.30, P <.001) of lesion occurrence compared to the cartilaginous vocal folds. Despite these strong trends in lesion distribution, there were no differences in the odds of lesion recurrence, growth, or in the time to recurrence, between anatomic subsites. Conclusions: RRP lesions are most likely to occur in the glottis, particularly the membranous vocal folds, compared with other regions of the larynx or trachea. However, all lesions demonstrate similar behavior with respect to recurrence, growth, and time to recurrence regardless of anatomic location. Level of Evidence: 3 Laryngoscope, 132:2403–2411, 2022.
KW - Recurrent respiratory papillomatosis
KW - anatomic distribution
KW - dysphonia
KW - prospective
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U2 - 10.1002/lary.30036
DO - 10.1002/lary.30036
M3 - Article
C2 - 35129220
AN - SCOPUS:85124470046
SN - 0023-852X
VL - 132
SP - 2403
EP - 2411
JO - Laryngoscope
JF - Laryngoscope
IS - 12
ER -