TREATMENT OF DYSPHONIA IN LARYNGEAL PAPILLOMATOSIS

Abstract

Laryngeal papillomatosis (LP) is a chronic, recurrent disease caused by human papillomavirus (HPV) infection, characterized by the growth of benign epithelial tumors within the larynx and respiratory tract. One of the most debilitating consequences of LP is persistent dysphonia, which often leads to significant deterioration in quality of life, particularly among individuals whose professional and social activities rely heavily on vocal communication. Despite the benign histological nature of papillomas, their tendency for recurrence, airway obstruction, and malignant transformation makes LP a serious condition requiring continuous medical attention [1].

The management of dysphonia in laryngeal papillomatosis is complex due to the chronic and recurrent nature of the disease. Conventional surgical interventions such as microlaryngoscopy with cold instruments or laser excision remain the gold standard for papilloma removal. However, these approaches are palliative rather than curative, as papillomas often recur within weeks or months [2]. Adjuvant pharmacological therapies, including antiviral agents, interferon, and bevacizumab injections, have been introduced to extend remission periods and improve vocal outcomes, but their long-term efficacy remains under investigation [3,4].

Recent studies highlight the importance of combined treatment strategies that integrate surgical, pharmacological, and rehabilitative approaches to improve voice quality and reduce recurrence. Voice therapy and rehabilitation techniques are increasingly recognized as valuable adjuncts, aiming not only to restore phonatory function but also to prevent maladaptive vocal behaviors that exacerbate dysphonia [5]. Furthermore, the introduction of vaccination against HPV has shown promise in reducing the incidence of recurrent respiratory papillomatosis, especially in younger populations [6].

This article aims to provide a comprehensive overview of the epidemiology, clinical features, and therapeutic strategies for managing dysphonia in patients with laryngeal papillomatosis. Particular emphasis is placed on the effectiveness of combined treatment approaches, their impact on voice outcomes, and the challenges associated with long-term management of this condition.