Oral Papilloma

Oral papilloma


     Laryngeal papillomatosis (oral papilloma disease) is a rare disease caused by human papilloma virus. In this disease occurring papillomas (benign tumors) are in the lining of the respiratory tree from the nose to the lungs, including the larynx and vocal chords. Most laryngeal papillomas (oral papillomas) occur before the age of three years. The tumors grow rapidly and can reach sizes that make breathing and swallowing a problem. After surgical removal, polyps tend to reoccur.


Diagnosis:


     At any change in voice or hoarseness, which lasts more than a month, you should read by a doctor. Sometimes the hoarseness may be the first symptom of cancer oral papilloma infestation. Apart from the general clinic examination and medical history, your doctor may do an examination of the larynx by indirect or direct laryngoscopy, from which he can view vocal cords.


Treatment for oral papilloma infestation:


     Damage caused by vocal abuse or misuse of the voice is easily prevented. In addition, most diseases that involve the voical string are reversibile. Treatment for the disease caused by oral papilloma is indicated by the doctor based on age, overall health, extension of lesions in the vocal chords, individual tolerance for specific medications and procedures etc.

     Conservative treatment includes avoiding excessive use of voice and putting to rest the vocal tract, eliminating risk factors such as smoking, stress, alcohol consumption, adequate hydration to prevent dryness of the neck.

     If an organic cause for the dysphonia is identified the substantive issue should be treated. Viral laryngitis usually resolves itself, while secondary bacterial infection should be treated with antibiotics. For node and polyps, their treatment may involve surgical resection.


Vaccination for HPV


     The vaccine recently introduced against infection with certain HPV types including oral papilloma, is marketed under the name of Silgard (or Gardasil).



     The vaccine does not treat HPV infection, warts occurring or existing cervical lesions. This is only a vaccine can help protect against infection caused by HPV types: 6, 11, 16 and 18. HPV types 16 and 18 have been incriminated in 70% of cancers and types 6 and 11 have been incriminated in 90% of genital warts.

     The vaccine may not provide 100% protection in all cases and cannot prevent other types of cervical cancer or infection with other HPV types than those contained in the vaccine.

     Administration: ADM is done in 3 shots in 6 months. Recommended standard 0-2-6 month schedule:

  • First dose
  • Second dose 2 months after first dose
  • The third dose 6 months after the first dose.

     In principle, the second dose should be given at least a month after the first dose, the third at least 3 months after the second dose and all 3 doses should be administered over a maximum of 1 year.

     It is administered intramuscularly in the deltoid region of upper portion of the arm or in the thigh.

     It is recommended for females with ages between 9 and 26 years who did not have sex or not yet come into contact with HPV types 6,11,16,18. It is not recommended before the age of 9 years, because not enough known data on Immunogenicity, safety and efficiency of its administration to children. Also, there are not enough studies of pregnant women, which make him not recommended during pregnancy.

     In case of HPV infection, there may benefit from vaccination if not already present at all 4 types of HPV.

     There is no known duration of protection after vaccination, as studies are still underway.

     Vaccination against HPV may not replace regular inspections by Papanicolau test.