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JRPP Surgical Video Galley

These videos demonstrate the diagnosis and treatment of juvenile recurrent respiratory papillomatosis (JRRP). In the first video, direct laryngoscopy under anesthesia is performed to examine the vocal cords.  The growths on the vocal cords are consistent with papillomas.  

When the disease is bulky and obstructing the airway, which is often how children with JRRP first present, an instrument called the microdebrider can be used to shave the bulk of the papilloma, as seen in the second video. This allows for rapid clearance of the papillomas, which are obstructing the majority of the patient’s airway.

When the disease is less bulky, it can often cause hoarseness or other changes with voice. In this third video, a laser is used to ablate the papillomas that are present directly on the vocal cords. A variety of lasers can be used, including the CO2 laser, the potassium titanyl phosphate (KTP) laser, and the pulsed-dye laser (PDL). At our Center, we routinely use the KTP laser with excellent outcomes.
Adjunct therapies have been developed for select patients who have severe JRRP needing frequent treatment. In this last video, injection of bevacizumab, or Avastin, is being performed after laser treatment. We also use cidofovir as an adjunct treatment in select patients.

 

Videos used with permission and provided by Karger