Cicatricial complications of respiratory papillomatosis surgical treatment at the department of Saint Petersburg State Pediatric Medical University clinical hospital in 2019–2021

Abstract

BACKGROUND: Respiratory papillomatosis requires combined treatment, adjuvant therapy and surgical treatment. Scarring complications often occur after surgical treatment. AIM: To determine the frequency of cicatricial complications of surgical treatment of respiratory papillomatosis in children. MATERIALS AND METHODS: A retrospective analysis of the medical histories of 49 children who received surgical treatment at the clinic of the Saint Petersburg State Pediatric Medical University for 3 years (from 2019 to 2021) was carried out. The data obtained were compared with the data of a meta-analysis conducted in 2022. RESULTS: In the otolaryngological department of Saint Petersburg State Medical University from 2019 to 2021, 49 children aged 1 to 17 years — 25 boys and 24 girls — received surgical treatment. Primary papillomatosis was detected in 9 patients. The first surgical intervention was at the age of 2 years in 12 children (24.5%). Combined treatment was used: endolaryngeal removal of laryngeal papillomas with microsurgical instruments and administration of interferon alpha-2b in the postoperative period. Of the 49 patients, scarring was detected in 16 (32.6%). However, 29 patients were operated only at the Saint Petersburg State Medical University clinic — the percentage of cicatricial complications among them was 20.6%. 20 patients turned to the Saint Petersburg State Medical University clinic after treatment in other institutions — the percentage of cicatricial complications among them was 50%. Of all 49 children examined, scarring occurred in the vocal region in 10 children (62.5%), in the larynx — in 2 children (12.5%), in both departments in 4 children (25%). Scarring changes were not detected in the sub-vocal part of the larynx. The number of operations per year for each child ranged from 1 to 7, and for 3 years (from 2019 to 2021), the number of operations reached 20. CONCLUSIONS: Scarring complications after surgical treatment of respiratory papillomatosis are quite common. It was revealed that the first surgical treatment is more often in the first 3 years of life. The choice of surgical technique affects the frequency of cicatricial complications, however, it is extremely difficult to avoid cicatricial complications as long as there is a need for surgical treatment.