Tracheal involvement in laryngeal papillomatosis

A review of 39 laryngeal papilloma patients at The Johns Hopkins Hospital revealed an incidence of subglottic and tracheal extension much higher than previously reported. Subglottic disease was present in 69% of patients and tracheal involvement in 26%. Factors associated with distal spread were the presence of subglottic papillomas, history of tracheostomy, total number of endoscopic resections, and the duration of disease. The relationship to the presence of viral antigen was cited. Detection and elimination of all papillomas is felt to be the key for the prevention of distal spread. The strategy of management is described.