Recurrent Respiratory Papillomatosis, Clinical Research And Midface Thrown To The Clinical Application Of The Surgery

Background: Juvenile-onset Recurrent Respiratory Papi1lomatosis is the common benign laryngeal tumor of child in the ENT. It has a upper relapse rate, so its treatment is the troublesome problem in the ENT department. There are multifarious means of therapy in the worldwide,the primary method is sill the surgical operation at present.Along with the improvement of the surgical technique ,the therapeutic efficacy is improved, it is not satisfyactory yet. Some patients relapse time after time.After operations through and through,they cann' t remove the cannula of tracheal.The patients suffered in their body and mind.The key point of therapy is how to remove the papilloma and to keep the respiratory tract to be unobstructed,moreover how to decrease the relapse rate as far as possible and to advance the quality of life.Objective:To discuss the pathoggeny, pathology, clinical situation, clinical process and therapy of Jo-RRP.From thepoint of view in clinic,to analyze the correlate factors such as:occurrence, development and prognosis in order to sum up a set of effective ways and means of treatment. Method:36 patients of Jo-RRP (male 19 cases/female 17 cases) who underwent surgical treatment in QiLu hospital of ShanDong university from 1993 to 2003 were summarized. The mean age was 3.1 years(range 10 / 12 to 13 years) . Surgical treatment included:excision of papilloma under laryngoscope, laser excision and laryngeal stoma laser excision of papilloma.To give systemic therapy of interferon after operation besides. Results: Among 36 patients, the group (=4 years old ) had 21 cases (58.3%) and the group( ≦ 2 years old) had 14 cases(38.9%).The pinnacle of episode age was 2 years. Sum of operations was 142 (including our hospital and outside), the mean time was 3. 94 per capita.The relapse rate after operation through and through was 72.7% in the group (≦ 2 years old ) and that was 51.2% in the other section (>2 years old).The difference was striking (P<0.05 ). The common spots to fall ill in order were: vocal cord (88.9%) , ventricular fold (80. 6%) , laryngeal ventricle (61. 1%) , laryngeal side of epiglottis (55.6%).The patients who underwent tracheotomy were easy to spread in trachea.The relapse rate gradually decreased along with the augment of therapy(operation + interferon)and the age.The complications of operation were mostly the long-term complications after operation,such as: laryngeal stenosis 5 cases and tracheal stenosis 1 case. Conclusion:The pinnacle of episode locates in 2 years old around.The clinical passage relates with thereinafter factors:age of episode,grownth mode of lesion and tracheotomy...