Postoperative Systemic Acyclovir in Juvenile-Onset Recurrent Respiratory Papillomatosis

: The Outcome Show less Sandipta Mitra, MBBS, Arindam Das, MBBS, MS, Debasish Ghosh, MBBS, MS, , First Published January 30, 2019 Research Article https://doi.org/10.1177/0145561318823311 Article information Free Access Article Information Article first published online: January 30, 2019 Sandipta Mitra, MBBS1, Arindam Das, MBBS, MS1, Debasish Ghosh, MBBS, MS1, Arunabha Sengupta, DLO, MS1 1Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post Graduate Medical Education and Research, SSKM Hospital, Kolkata, West Bengal, India. Corresponding Author: Arindam Das, MBBS, MS, Department of Otorhinolaryngology and Head Neck Surgery, Institute of Post Graduate Medical Education and Research and SSKM Hospital, 244 A.J.C Bose Road, Kolkata 700020, West Bengal, India. Email: arindam_cnmch@hotmail.com A prospective observational study was conducted consisting of 21 patients of Juvenile-onset recurrent respiratory papillomatosis, attending the Department of Otorhinolaryngology and Head Neck Surgery at our institution, who underwent surgical excision of the papillomas followed by oral acyclovir postoperatively. The study was aimed to observe the effect of systemic acyclovir on postoperative outcomes in children having recurrent respiratory papillomatosis undergoing primary surgical excision. It was observed that the mean interval between surgeries as well as the number of surgical interventions required was significantly lesser when acyclovir was used as a postoperative adjuvant than when surgery was done alone. Hence, the interval between successive surgeries, or in other words, the time interval between relapse of the disease could be prolonged significantly with the use of postoperative systemic acyclovir. Thus, the disease could be controlled for longer periods and repeated surgeries avoided. Keywords respiratory papillomatosis, human papilloma virus, microlaryngeal surgery, acyclovir References 1. Duggan, MA, Lim, M, Gill, MJ, Inoue, M. HPV DNA typing of adult-onset respiratory papillomatosis. Laryngoscope. 1990;100(6):639–642 Google Scholar | Crossref 2. Larson, DA, Derkay, CS. Epidemiology of recurrent respiratory papillomatosis. APMIS. 2010;118(6-7):450–454. Google Scholar | Crossref 3. Rabah, R, Lancaster, WD, Thomas, R, Gregoire, L. Human papillomavirus-11-associated recurrent respiratory papillomatosis is more aggressive than human papillomavirus-6-associated disease. Pediatr Dev Pathol. 2001;4(1):68–72. Google Scholar | Crossref 4. Silverberg, MJ, Thorsen, P, Lindeberg, H, Grant, LA, Shah, KV. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory papillomatosis. Obstet Gynecol. 2003;101(4):645–652. Google Scholar | Crossref 5. Novakovic, D, Cheng, ATL, Zurynski, Y. A prospective study of the incidence of Juvenile-onset recurrent respiratory papillomatosis after implementation of a National HPV Vaccination Program. J Infect Dis. 2018;217(2):208–212. Google Scholar 6. Mudry, P, Vavrina, M, Mazanek, P, Machalova, M, Litzman, J, Sterba, J. Recurrent laryngeal papillomatosis: successful treatment with human papillomavirus vaccination. Arch Dis Child. 2011;96(5):476–477. Google Scholar | Crossref 7. Förster, G, Boltze, C, Seidel, J, Pawlita, M, Müller, A. [Juvenile laryngeal papillomatosis—immunisation with the polyvalent vaccine gardasil]. Laryngorhinootologie. 2008;87(11):796–799. Google Scholar 8. Derkay, CS, Wiatrak, B. Recurrent respiratory papillomatosis: a review. Laryngoscope. 2008;118(7):1236–1247. Google Scholar | Crossref 9. Böttcher, A, Jowett, N, Kucher, S. Use of a microsecond Er:YAG laser in laryngeal surgery reduces collateral thermal injury in comparison to superpulsed CO2 laser. Eur Arch Otorhinolaryngol. 2014;271(15):1121–1128. Google Scholar | Crossref 10. McGlennen, RC, Adams, GL, Lewis, CM, Faras, AJ, Ostrow, RS. Pilot trial of ribavirin for the treatment of laryngeal papillomatosis. Head Neck. 1993;15(6):504–512. Google Scholar | Crossref 11. Wachsman, M, Petty, BG, Cundy, KC. Pharmacokinetics, safety and bioavailability of HPMPC (cidofovir) in human immunodeficiency virus-infected subjects. Antiviral Res. 1996;29(2-3):153–161. Google Scholar | Crossref 12. Derkay, C . Cidofovir for recurrent respiratory papillomatosis (RRP): a re-assessment of risks. Int J Pediatr Otorhinolaryngol. 2005;69(11):1465–1467. Google Scholar | Crossref 13. Kimberlin, DW, Whitley, RJ, Wan, W. Oral acyclovir suppression and neurodevelopment after neonatal herpes. N Engl J Med. 2011;365(14):1284–1292. Google Scholar | Crossref 14. Uchoa, UBC, Rezende, RA, Carrasco, MA, Rapuano, CJ, Laibson, PR, Cohen, EJ. Long-term acyclovir use to prevent recurrent ocular herpes simplex virus infection. Arch Ophthalmol. 2003;121(12):1702–1704. Google Scholar | Crossref 15. Arndt, KA . Adverse reactions to acyclovir: topical, oral, and intravenous. J Am Acad Dermatol. 1988;18(1 pt 2):188–190. Google Scholar | Crossref