Objective: To evaluate laryngeal sequelae from surgical treatment of recurrent respiratory
papillomatosis in children, as well as associated risk factors. Methods: Case-control
study. Medical record data analysis of 50 children with recurrent respiratory papillomatosis,
divided into two groups: with and without laryngeal sequelae. The group of
patients with laryngeal sequelae was compared to those without sequelae in regard to
the onset of disease, age at first surgery, number and frequency of surgeries, disease
stage, and type of surgery (CO2 laser, cold forceps). Results: 23 patients (46%) sustained
laryngeal sequelae. The most frequent sequela was anterior commissure synechia (17
patients [34%]), followed by glottic stenosis (six patients [12%]). There was no statistically
significant difference between groups with and without laryngeal sequelae regarding
the disease onset (p = 0.93), age at first surgery (p = 0.68), number of surgeries
(p = 0.22), annual frequency of surgery (p = 0.93), presence of papilloma in anterior
(p = 0.430) or posterior commissure (p = 0.39), and type of surgery (p = 0.27). The
Derkay anatomical score (a staging system that assesses the extent of the disease in the
aerodigestive tract) was significantly higher in the laryngeal sequelae group (p = 0.04).
Conclusion: Laryngeal sequelae are a frequent complication of recurrent respiratory
papillomatosis surgical treatment in children, particularly anterior commissure synechiae
and glottic stenosis. Advanced stages are associated with increased risk of laryngeal
sequelae after surgery.
