Diagnostic challenges of laryngeal papillomatosis and its implications among children in developing country

Int J Pediatr Otorhinolaryngol. 2009 Apr;73(4):593-5. doi: 10.1016/j.ijporl.2008.12.009. Epub 2009 Jan 20.

Abstract

Objectives: To create an awareness of laryngeal papillomatosis in children and the implications of its mismanagement among the general practitioner and paediatricians, and to offer suggestions on its diagnostic techniques.

Method: Medical records of children with histologically confirmed laryngeal papillomatosis managed at the Otorhinolaryngology department of University College Hospital Ibadan Nigeria through 1993-2007 were reviewed for essential clinical data.

Results: There were 38 paediatric patients, 23 (60.53%) males and 15 (39.47%) females, with laryngeal papillomatosis. Only 2 (5.26%) of these patients were correctly diagnosed by the referring clinicians. Diagnosis was delayed for 5 weeks to 3 months. About 90% of these patients had emergency tracheostomy and 92% had surgical excision for 2 sections or less.

Conclusion: Laryngeal papillomatosis misdiagnosis and mismanagement were common in our environment due to clinicians not being conversant with the disease entity. It should therefore be considered an important differential diagnosis in children with laryngeal symptoms to improve its clinical outcome. Otorhinolaryngologists should always be involved early without delay in the management.

MeSH terms

  • Airway Obstruction / etiology
  • Airway Obstruction / surgery*
  • Child
  • Child, Preschool
  • Developing Countries
  • Diagnosis, Differential
  • Female
  • Hospitals, University
  • Humans
  • Infant
  • Laryngeal Neoplasms / diagnosis*
  • Laryngeal Neoplasms / surgery
  • Laryngoscopy
  • Male
  • Nigeria
  • Papilloma / diagnosis*
  • Papilloma / surgery
  • Retrospective Studies
  • Tracheostomy