Recurrent respiratory papillomatosis: clinical presentation, treatment modalities, and outcomes in Khartoum state

Abstract
Background
In this hospital-based cohort study, a total number of 52 patients with recurrent respiratory papillomatosis were studied. The medical histories of all the patients were taken and physical examination was conducted thoroughly. Types of surgeries were also observed and the sites of papillomatous lesions were identified. The patients then followed up after surgeries to assess the outcomes and to evaluate the satisfaction levels of the patients.

Result
There was obvious gender predilection toward male patients. Ninety percent of the cases were younger than 20 years old, and 50% of the cases were found to be in the group of 5–10 years old. The most predominant symptom that had been noticed in all of the patients was the change of voice. The study also found that around 46% of the patients had a history of surgical interventions as trials to treat the disease. Acyclovir tabs were prescribed for only 4 patients. No other forms of adjuvant therapies were prescribed. It is also showed that around 65.4% of the cases underwent surgical removal of the papillomata by debulking using cold steel. 30.8% underwent laser and two patients underwent coblation surgeries. Forty-two percent of the patients reported good and satisfactory outcomes with obvious relief from presenting symptoms and no apparent papilloma after IDL examination.

Conclusion
Recurrent respiratory papillomatosis presents with a highly variable clinical course in both juvenile and adult patients, with a spectrum from indolent to aggressive disease. But the severity of the condition is more among the younger ages. Change of voice was the first symptom in all of the cases. The use of adjuvant medical treatment in Sudan to treat respiratory papillomatosis is not a routine practice.