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Ribavirin treatment for juvenile respiratory papillomatosis

Published online by Cambridge University Press:  29 June 2007

G. A. J. Morrison ,
B. Kotecha  and
J. N. G. Evans
G. A. J. Morrison*
Affiliation:
Department of Paediatric Otolaryngology, The Hospital for Sick Children, Great Ormond Street, London WC1N 3JH.
B. Kotecha
Affiliation:
Department of Paediatric Otolaryngology, The Hospital for Sick Children, Great Ormond Street, London WC1N 3JH.
J. N. G. Evans
Affiliation:
Department of Paediatric Otolaryngology, The Hospital for Sick Children, Great Ormond Street, London WC1N 3JH.
*
Mr G. A. J. Morrison, 29 Marney Road, London SW11 5EW.
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Abstract

Juvenile respiratory papillomatosis involving the tracheo-bronchial tree imposes a significant management problem and is sometimes life threatening. The mainstay of treatment is repeated vapourization with a CO2 laser. To date, adjunctive medical treatments have been of limited value. A tracheostomized child with extensive laryngo-tracheo-bronchial papillomatosis who has required bronchoscopic lasering at two-weekly intervals for three years was treated with ribavirin, a broad spectrum anti-viral agent. The drug was administered in nebulized form using a small particle aerosol generator (S.P. A.G.) to the lower respiratory tract (6 gm/150 ml over nine hours) on three consecutive nights every two weeks over seven weeks and also administered orally (15 mg/kg/day). Endoscopic assessments were made every two weeks. At 14 days the papillomata were regressing and far less lasering was required. No further lasering was required up to 56 days. One month after stopping the ribavirin, however, a few sessile papillomata in the tracheo-bronchial tree had recurred and were treated with the laser. No adverse reactions were encountered. During the treatment period there was a significant reduction in the frequency of therapeutic endoscopies. This promising response requires further evaluation to define the role of ribavirin in the treatment of juvenile respiratory papillomatosis.

Keywords

PapillomaLaryngeal neoplasmsTracheal neoplasmsBronchial neoplasmsRibavirin
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 5 , May 1993 , pp. 423 - 426
Copyright
Copyright © JLO (1984) Limited 1993

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