The duration of tracheostomy dependence in patients with juvenile-onset recurrent respiratory papillomatosis

Acta Otolaryngol. 2022 Jul-Aug;142(7-8):610-615. doi: 10.1080/00016489.2022.2098532. Epub 2022 Jul 25.

Abstract

Background: Tracheostomy is a vital therapy for juvenile-onset recurrent respiratory papillomatosis (JORRP) to maintain an adequate airway in an emergency, yet the relationship between cannulation duration and prognosis has not been extensively explored.

Objectives: To investigate the predictive influence of the duration of tracheostomy dependence on JORRP remission.

Materials and methods: A retrospective review of JORRP patients (n = 77) with tracheostomy treated in Beijing Tongren Hospital was performed.

Results: The rate of decannulation was 72.7%. After decannulation for one year, the percentage of distal spread fell from 42.9 to 30.4%. Twenty-six of 77 patients (33.8%) had remission of their disease, 40 (51.9%) continued to have active disease while 11 (14.3%) died during follow-up. The cannulation duration was positively correlated with the overall duration of this disease (r = 0.6). The cut-off point of 34.9 months for cannulation duration indicated the highest predictive value of remission. Duration of cannulation >34.9 months (OR = 0.33) and distal spread (OR = 0.29) decreased odds of remission.

Conclusion: The study demonstrates that the time span before decannulation indicates the severity of disease and cannulation aggravates the distal spread. Patients with cannulation duration ≤ 34.9 months after tracheostomy are prone to possess a relatively pleasant prognosis.

Keywords: Juvenile-onset recurrent respiratory papillomatosis; cannulation duration; prognosis; tracheostomy.

MeSH terms

  • Humans
  • Papillomavirus Infections* / complications
  • Papillomavirus Infections* / surgery
  • Respiratory Tract Infections* / surgery
  • Retrospective Studies
  • Tracheostomy
  • Tracheotomy

Supplementary concepts

  • Recurrent respiratory papillomatosis