• Medical Lasers
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• 제9권2호
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• pp.126-133
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• 2020

Recurrent respiratory papillomatosis (RRP) is a benign tumor that occurs in the respiratory tract, especially in the larynx. The etiology of RRP is human papillomavirus (HPV). According to the age of occurrence, RRP is divided into childhood-onset and adult-onset types. Generally, childhood-onset RRP shows a high recurrence rate and diffuse involvement in the respiratory tract. Adult-onset RRP is more localized and appears more frequently as a solitary lesion. It may be the result of sexual transmission or the proliferation of latent HPV infections. At present, the treatment of choice for RRP is CO₂ laser ablation. In addition, pulse dye laser or KTP (KTiOPO: potassium-titanyl-phosphate) lasers are also used. Non-surgical adjuvant therapies can be applied in cases requiring repetitive surgery or with diffuse extensions. This review will introduce the clinical features of RRP and various treatment options including lasers.

• 대한후두음성언어의학회지
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• 제31권1호
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• pp.7-12
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• 2020

Recurrent respiratory papillomatosis (RRP) is characterized by repeated recurrence in the respiratory system, such as the pharynx, larynx, and trachea, caused by the human papilloma virus. The main treatment is surgical removal of the papilloma. However repeated recurrence of RRP in multiple areas is burdened for the surgeon. In addition to the surgery, various adjuvant therapies have been studied to reduce the recurrence. Literature review was conducted with a focus on the adjuvant treatments for RRP.

• Tuberculosis and Respiratory Diseases
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• 제54권3호
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• pp.346-352
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• 2003

저자들은 호흡곤란, 객담, 기침을 주소로 내원한 23세 남자환자에서 기관지 내시경 및 VATS로 시행한 조직검사상 후두와 함께 기관, 기관지 및 폐실질을 침범한 유두종증으로 진단받고 interferon-${\alpha}$ 치료 후 호전을 보인 재발성 호흡기계 유두종증 1예를 경험하였기에 보고하는 바이다.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 2003년도 제19회 학술대회
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• pp.195-197
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• 2003

호흡기 유두종(recurrent respiratory papillomatosis, RRP)은 호흡기의 편평상피에 발생하는 바이러스성 질환으로 잦은 재발과 증식을 특징으로 한다. 다발성으로 발생하는 경우 소아에서는 생명을 위협하기도 하는 치명적인 질환이다. 호흡기 유두종의 발생에 가장 중요한 원인은 유두종 바이러스(human papilloma virus : HPV)의 감염으로 생각된다. HPV는 Papovaviridae군에 속하는 이중쇄 구조의 DNA virus로서 피부 사마귀, 항문성기기관 및 호흡소화기관의 양성 또는 악성 편평상피 유두종을 유발하는 원인 인자로 알려져 있다. 최근까지의 발표에 의하면 HPV 6, 11형이 호흡기 유두종증의 주원인이라고 알려져 있다. 원인 바이러스의 검출방법에 대하여 최근 DNA chip을 이용하는 방법이 개발되었고, 자궁경부암과 암 전구병변에서 인 유두종 바이러스의 아형에 대한 연구가 발표된 바 있다. (중략)

• 대한후두음성언어의학회지
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• 제20권2호
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• pp.136-140
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• 2009

Background and Objectives: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the aerodigestive tract. We aimed to estimate the effect of intralesional injections of cidofovir in patients with RRP. Materials and Method: Within the period from January 2003 to July 2007, 13 patients aged 2 to 61 years were treated with intralesional injections of cidofovir combined with surgical excision of RRP. Cidofovir was injected intralesionaly at a concentration of 5 mg/cc after complete removal of the papilloma with $CO_2$ laser or microdebrider. We evaluated the effect of intralesional cidofovir therapy by comparing pre-treatment mean interval of recurrence with post-treatment interval of recurrence. Results: Of 13 patients, two patients showed complete response during follow up period and four patients showed partial response. Seven patients did not respond to cidofovir at all. Mean pre-treatment mean interval of recurrence was 9 months and mean post-treatment interval of recurrence was 13.1 months (p=0.039). There was a statistical significance between the injected dose of cidofovir and post-treatment interval of recurrence (p=0.009). There were no local or systemic side effects caused by cidofovir. Conculsion : Intralesional injection of cidofovir seems to have a potential of a safe and effective adjuvant therapy of RRP. There was a positive correlation between the injected dose of cidofovir and patient clinical outcomes so that administration of higher doses and more frequency of injections should be needed to reduce recurrence. Further study regarding injection therapy regimen for RRP is required.

• Tuberculosis and Respiratory Diseases
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• 제65권5호
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• pp.390-395
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• 2008

연구배경: 재발성 호흡기계 유두종증은 기관을 따라 다발성 유두종이 반복적으로 재발하는 매우 드문 질환이다. 1980년대 이후, 소아의 재발성 유두종증에 보조적 치료로 인터페론이 사용되어 왔다. 그러나, 성인 환자에서의 유효성 등에 대하여는 많은 연구 등이 필요하다. 2002년 이후, 삼성서울병원에서는 성인의 재발성 호흡기계 유두종증 환자들에서 재발을 예방하기 위해, 인터페론을 사용하여 왔다. 이에 본 저자들은 재발성 호흡기계 유두종증 성인 환자에서 인터페론의 장기간 사용 효과를 알아보고자 하였다. 방 법: 기관지내시경과 조직학적으로 확인된 5명의 재발성 호흡기계 유두종증 환자에서 타 병원에서 치료한 기록 등을 포함한 의무기록 등을 조사하였다. 레이저 소작술을 포함한 치료적 기관지내시경 시술 후, 모든 환자는 2개월 간격으로 인터페론-알파 600만 단위를 피하주사 하였다. 추가적인 치료적 기관지내시경 시술은 추적 검사 중 환자의 증상 등을 확인하여 필요 시 시행하였으며, 기관지 내시경 또는 켬퓨터 단층 촬영 등을 추적 조사하였다. 결 과: 모든 환자들의 연령의 중앙값은 44세(범위 13~68세), 남녀비는 3 : 2, 유두종증 기간의 중앙값은 31년(범위 1~45년)이었다. 소아형과 성인형 유두종증은 각각 3명과 2명이었으며, 2명의 환자는 진단 당시 기관절개술을 시행 받았던 과거력이 있었다. 인터페론 치료기간의 중앙값은 56개월(범위 12~66개월)이었다. 인터페론 치료 후 2명의 환자는 12개월과 36개월에 각각 완전완화를 보였으며, 나머지 3명의 환자는 부분완화를 보여 레이저 치료의 횟수가 중요하게 감소하였다. 결 론: 재발성 호흡기계 유두종증 환자에서 인터페론의 보조적 치료의 적정 용량과 기간 등은 향후 더 많은 연구 등을 필요로 하며, 오랜 기간 지속된 성인의 재발성 호흡기계 유두종증 환자에서 2개월 간격의 인터페론의 치료는 안정적이며 효과적이다.

• 대한후두음성언어의학회지
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• 제22권1호
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• pp.30-33
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• 2011

Laser is a relatively recent addition to laryngeal surgery. Since their invention, laser use and applications have expanded rapidly. The use of lasers in surgery has offered a time- and cost-efficient alternative to cold surgical techniques and has been used in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke's edema). Despite the notable benefits, laser surgery is not without disadvantages. Laser heat can increase scarring and cause damage to adjacent tissue. With laser laryngeal microsurgery, there is potential for airway fire, endolaryngeal bleeding, perichondritis, chondritis, granuloma, surgical emphysema, laryngeal stenosis and web formation, postoperative edema and swallowing problem. Surgeons should be known about these complications and could manage properly.

• 대한후두음성언어의학회지
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• 제29권2호
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• pp.76-78
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• 2018

With recent developments in medical technology and the introduction of various types of lasers, the role of fiberoptic laryngeal laser surgery (FLS) in laryngology has been significantly expanded. FLS are typically performed under local anesthesia, and patients may return to normal activities immediately after the procedure. This corresponds to the current trend of minimally invasive surgery and may limit unnecessary general anesthesia, reduce medical costs, and increase patient compliances. Main indications of FLS procedure were vocal polyp, recurrent respiratory papillomatosis, vocal fold granuloma and vocal fold dysplasia. In this review, we discuss practical tips and unique value of FLS.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7029-7035
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• 2014

Certain types of human papillomaviruses (HPVs) are undoubtedly involved in genesis of human malignancies. HPV plays an etiological role in cervical cancer, but also in many vaginal, vulvar, anal and penile cancers, as well as head and neck cancers. In addition, a number of non-malignant diseases such as genital warts and recurrent respiratory papillomatosis are attributable to HPV. Moreover, HPV forms have detected in several other cancers including esophageal squamous cell carcinoma, lung, prostate, ovarian, breast, skin, colorectal and urinary tract cancers, but associations with etiology in these cases is controversial. The aim of this systematic assessment was to estimate the prevalence of HPV infection and HPV types in HPV-associated cancers, HPV-related non-malignant diseases and in cancers that may be associated with HPV in Iran. The present investiagtion covered 61 studies on a variety of cancers in Iranian populations. HPV prevalence was 77.5 % and 32.4% in cervical cancer and head and neck cancers, respectively. HPV was detected in 23.1%, 22.2%, 10.4%, 30.9%, 14% and 25.2% of esophageal squamous cell, lung, prostate, urinary tract cancers, breast and skin cancers, respectively. HPV16 and 18 were the most frequent HPV types in all cancers. The findings of present study imply that current HPV vaccines for cervical cancer may decrease the burden of other cancers if they are really related to HPV.

• 대한후두음성언어의학회지
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• 제32권2호
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• pp.51-55
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• 2021

There are several lasers available for office-based or suspension microlaryngoscopy laser procedures in the treatment of laryngeal diseases. Each has advantages and disadvantages given the depth of penetration per unit of power, absorption in water, spectral absorption characteristics, mode of delivery, safety, and cost. It is important to note that while the proper selection of indication of treatment based on a laser wavelength is critical, of equal importance is selecting the appropriate power setting, focal length (or spot size), and time of exposure. The photoangiolytic lasers precisely target hemoglobin within the microcirculation of the highly vascularized tissue and may have better hemostatic effects and preservation of surrounding normal tissue than the CO₂ laser. Although the choice of laser is purely theoretical and cannot be accurately concluded which parameters of laser (wattage and pulse width) were best to use, photoangiolytic laser surgery is safe and effective for specific laryngeal lesions. In this review, indications for photoangiolytic laser procedures for various laryngeal diseases, laser settings and surgical techniques for specific laryngeal lesions including sulcus vocalis, laryngeal dysplasia, and recurrent respiratory papillomatosis will be introduced. Pros and cons of in-office laser surgery using photoangiolytic laser and flexible CO₂ laser will also be addressed.