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General notions of epidemiology, etiopathogenesis and treatment in recurrent laryngeal papillomatosis (literature review)

Recurrent laryngeal papillomatosis is a benign tumor of the respiratory tract caused by HPV type 6 or 1 infection. It is considered a manageable rather than curable disease due to its high recurrence rates and unpredictable clinical course. The unique molecular characteristics of the virus induce cell proliferation causing airway obstruction. The main symptoms are hoarseness, inspiratory and expiratory screaming, dysphagia. The mechanisms responsible for the variability of clinical course and the persistence of latent HPV infection remain unknown. It is believed that both the adaptive and the innate immune response given by patients with papillomatosis support chronic infection. Patients with laryngeal papillomas are not able to produce an effective HPV-specific T cell response, as shown by an altered CD8 + subgroup and Th1 / Th2 cytokine imbalance with suppression of the Th1 response. There is a genetic association between certain severely disease-type HLA genes and down-regulation of type I HLA genes. Surgical excision, including new methods such as microdebrider and CO2 laser surgery, aims to provide a respiratory tract. and improve the voice, but can also cause serious complications such as airway stenosis. Recent advances in immune system research may provide an improvement in our treatment modalities and prevention strategies in this pathology.