Clinical evaluation of pediatric patients with recurrent respiratory papillomatosis.: A longitudinal study at a Saudi Arabian tertiary care center.

OBJECTIVES: To study the clinical evaluation of recurrent respiratory papillomatosis (RRP) patients and the factors associated with the improvement in the Derkay's score as a measure of disease severity. METHODS: A retrospective cohort that included all juvenile RRP patients who were admitted to King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between September 2015 and June 2022 and underwent surgical debulking. RESULTS: A total of 16 patients were eligible to join our study. Among them, 7 patients were males. Hoarseness of voice was the most frequent symptom. The median period of the follow-up was 56 months. Complete remission was achieved in 31.3%. The univariate linear regression model revealed that the cidofovir-treated patients had a significant reduction in the change value of Derkay's score compared to those without treatment (regression coefficient= -5.83, 95% confidence interval [CI]: [-11.5 to -0.143], p=0.045). Also, the increased first Derkay's score decreased the change value and subsequently increased the improvement chance of the disease (regression coefficient= -0.424, 95% CI: [-0.764 to -0.083], p=0.018). However, in the multivariate regression model, both variables showed non-significant results. CONCLUSION: cidofovir treatment and higher Derkay's scores affected the disease improvement.

Endoscopic Anterior Laryngotracheal Reconstruction.

This article introduces a new endoscopic technique for anterior laryngotracheal reconstruction (LTR) using costal rib cartilage grafting in a 2-year-old patient with acquired Grade III subglottic stenosis. The procedure involves an endoscopic incision in the cricoid cartilage's anterior midline and successful outcomes were achieved without complications. The study emphasizes the benefits of this approach, such as reduced hospital stays, shorter operation time, and decreased scarring, but acknowledges the necessity for further human trials to validate its effectiveness in treating different grades of laryngeotracheal stenosis. Laryngoscope, 2024.