Objective: To explore the long-term therapeutic effects of tracheotomy on juvenile onset recurrent respiratory papillomatosis in children.
Methods: Between 1993 and 2007, 86 cases of juvenile onset recurrent respiratory papillomatosis (JRRP) in children were encounted and divided into tracheotomy group and conventional surgery group, the clinical data of these children were retrospectively analyzed.
Results: There were 29 cases in tracheotomy group, the time of carrying tracheal casing pipe was 13 - 66.5 months, the operative times of every case was 4 - 9 times (median 7), there were 27 cases with more than 2 years release after extubation. There were 2 cases with tumor dissemination into incision of trachea and endotracheal, one case lost to follow up and the other one dead. No case developed laryngotracheal stenosis and severe complication. There were 57 cases in conventional surgery group, the operation times of every case was 9 - 32 times (median 18). Fifty-three cases with no recurrence after follow up for more than one year; 2 cases with trachea tumor dissemination, and after operation, no recurrence after 2 years follow up. Two cases with endotracheal dissemination, one case lost to follow up and the other one dead. No case developed laryngotracheal stenosis and severe complication. The voice assessment result of tracheotomy group was obviously better than that in the conventional surgery group, the difference had statistical significance (χ(2) = 33.16, P < 0.005), the tumor dissemination rate of the two groups had no statistical significance (χ(2) = 0.0026, P > 0.05).
Conclusions: Tracheotomy significantly reduce the operative times, give the greatest degree of preservation of laryngeal function, and it do not increase the tumor dissemination into trachea. Tracheotomy is an effective method of treatment in children with a high rate of recurrence, and with poor economic conditions, and difficult to follow-up. It can improve the long-term life quality of the children.