Retrospective Analysis of Patients with Juvenile Laryngeal Papillomatosis in ENT-CCF at CNHU-HKM/Benin: Literature Review.

Abstract

Objective: Laryngeal papillomatosis is a rare benign tumor affecting the laryngeal mucosa. Its precise etiopathogenesis remains unknown to date. The aim of this study was to investigate the epidemiological profile, diagnostic characteristics, therapeutic ap­proaches, and outcomes of patients with laryngeal papillomatosis.

Method: This was a descriptive cross-sectional study conducted at the Ear, Nose, and Throat (ENT) Clinic of CNHU-HKM/BENIN from January 1, 2010, to December 31, 2020. Laryngeal papillomatosis was confirmed through laryngeal biopsy. The variables studied included frequency, age, gender, clinical presentation, paraclinical findings, therapeutic approaches, and patient outcomes.

Results: Twenty-eight (28) cases of laryngeal papillomatosis were identified over an 11-year period, resulting in an annual incidence rate of 2.54 cases. The average age of the patients was 13.74 years, with a range from 19 months to 45 years. Females were more com­monly affected, with a sex ratio of 0.6 (15/24). Dyspnea was the primary reason for consultation in 17 out of 24 patients, even though all patients initially reported hoarseness as a symptom. In nine out of seventeen (09/17) patients, emergency tracheostomy was required due to severe laryngeal dyspnea at stage III according to the Chevalier Jackson and Pineau classification. Laryngeal biopsy was performed in all patients, confirming the diagnosis of laryngeal papillomatosis. Surgical debulking was performed in all patients, and in two cases, it was combined with CO2 laser vaporization of lesions outside of our hospital. Recurrences were frequent, ranging from 1 to 9, with at least one recurrence observed in 13 out of 24 patients. Two patients regained a normal voice, while the remaining patients experienced varying degrees of persistent phonatory sequelae. Four (04) patients were successfully decannulated, but one out of the five (1/5) remaining patients with a tracheostomy tube unfortunately passed away.

Conclusion: Laryngeal papillomatosis is a condition that is predominantly common in children. This study conducted in Benin high­lights that the primary treatment approach for this condition is surgical, specifically through endoscopy. The limitation of available medical equipment and technology hinders the exploration of other therapeutic alternatives.