Laryngeal Papillomas: Symptoms, Causes, and Treatment Options

Laryngeal papillomatosis issues?

Hello, Doctor 👋～ I noticed a foreign body sensation in my upper larynx about 3 to 4 months ago, as if there is a small polyp.
Sometimes it feels less noticeable, but it becomes more apparent when I eat hot food.
A few days ago, I visited an ENT specialist, and the doctor diagnosed it as a benign papilloma (I saw in the mirror that there seems to be a bit of excess tissue in my throat).
The doctor performed electrocautery in the office but mentioned (sorry to say 😳) that there is too much information online, so I would like to ask a professional:
1.
If it is an oral papilloma, is it usually transmitted through sexual intercourse from a partner who is an HRV carrier, thus infecting the female?
2.
I have seen other cases and feel that my situation resembles granulation tissue; how does this differ from a papilloma?
3.
If I have been infected, does that mean I am also an HRV carrier now? Would it be prudent to undergo testing?
4.
Currently, I have a polyp in my mouth (about 0.5 cm), could there be infections in other areas as well? (I have no unusual symptoms in the genital or hand areas.)
5.
Since I am married and have a long-term monogamous partner, if it is a papilloma, does the male partner need to be checked as well? What specialty should the male partner consult?

Xiao R, 40~49 year old female. Ask Date: 2022/12/16

Dr. Li Jiaxuan reply Otolaryngology

1.
HPV infection is possible.
2.
There is a potential for papillomas to undergo malignant transformation; generally, most granulomas are benign.
3.
For HPV infection, you can consult an infectious disease specialist.
4.
It is possible; if there are obvious papillomas, there are usually some symptoms.
There is no need to worry excessively, but it is recommended to have an examination by an otolaryngologist and a gynecologist.
Wishing you good health.

Reply Date: 2022/12/16

More Info

Laryngeal papillomas, commonly caused by the human papillomavirus (HPV), are benign tumors that can develop in the larynx (voice box). These growths can lead to various symptoms and require careful management. Here’s a comprehensive overview of the condition, including symptoms, causes, and treatment options.

Symptoms
The primary symptoms of laryngeal papillomas include:
- Hoarseness: A change in voice quality is often the first noticeable symptom.

- Sore throat: Patients may experience discomfort or pain in the throat.

- Difficulty breathing: In severe cases, the growths can obstruct the airway, leading to breathing difficulties.

- Coughing: A persistent cough may occur, sometimes accompanied by the sensation of a lump in the throat.

- Stridor: This is a high-pitched wheezing sound that occurs when breathing, indicating potential airway obstruction.

Causes
Laryngeal papillomas are primarily caused by HPV, particularly types 6 and 11, which are known to cause benign lesions. The transmission of HPV can occur through:
- Direct contact: This includes sexual contact, which is why it is often associated with oral and genital warts.

- Vertical transmission: In some cases, a mother can transmit the virus to her child during childbirth, leading to juvenile laryngeal papillomatosis.

Differentiating from Other Conditions
You mentioned the possibility of your condition resembling a "肉芽增生" (granulation tissue). Granulation tissue is a normal part of the healing process and typically appears at the site of injury or inflammation. In contrast, laryngeal papillomas are viral-induced growths that can recur after treatment. They are distinct in their etiology and management.

Diagnosis and Testing
If you suspect HPV infection, it is advisable to consult a healthcare provider for testing. While there is no routine test for HPV in the throat, a laryngoscopy can help visualize the growths. If necessary, a biopsy may be performed to confirm the diagnosis and rule out malignancy.

Treatment Options
The treatment for laryngeal papillomas typically involves:
- Surgical removal: This is often the first line of treatment. Techniques such as laser surgery or microdebrider excision can be employed to remove the papillomas.

- Adjunct therapies: In some cases, antiviral medications or immunotherapy may be considered to reduce the recurrence rate.

- Regular monitoring: Due to the tendency for papillomas to recur, regular follow-up appointments with an ENT specialist are crucial.

Partner Considerations
Regarding your concerns about your partner and HPV:
1. Transmission: If you have been diagnosed with laryngeal papillomas, it is possible that your partner may also be a carrier of HPV. However, not everyone exposed to HPV develops symptoms or lesions.

2. Testing for Partners: It is advisable for your partner to consult a healthcare provider for evaluation. Men can be assessed by urologists or primary care physicians, who can perform examinations and discuss any necessary testing.

Conclusion
Laryngeal papillomas are benign but can significantly impact quality of life due to their symptoms. It is essential to work closely with an ENT specialist for diagnosis and management. If you have concerns about HPV transmission or your partner's health, open communication and medical consultation are key. Regular monitoring and appropriate treatment can help manage the condition effectively.

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