Papilomas y papilomatosis laríngea. Tratamiento con láser CO2. Nuestra experiencia en 15 años / Papillomas & laryngeal papillomatosis. Treatment with CO2 laser surgery. Our experience over 15 years

Objetivo: Mostrar la experiencia con microcirugía láser CO2 como tratamiento de la papilomatosis laríngea. Analizamos parámetros diversos, entre ellos: edad media, género, tasa de recidiva, serotipo viral. Material y método: Se realiza un estudio descriptivo retrospectivo, recogiendo 29 casos diagnosticados y tratados de papiloma laríngeo mediante microcirugía asistida con láser CO2, entre 1995 y 2010. Resultados: Esta patología es más prevalente en el sexo masculino, 65,5%; con leve predominio de única localización laríngea frente a multilocalización de lesiones. Se detectó DNA vírico del Virus del Papiloma Humano (HPV) en el 75,8% de los casos, predominaron los subgrupos 6 y 11, entre otros. Presentaron recidiva el 44,8% de los casos, con una media de recidiva de 2–3 episodios por paciente. Se encuentran en remisión (sin recidiva en últimos 2 meses) el 20,7% de casos; en aclaramiento (sin recidiva aparente en últimos 3 años) el 34,5% y en curación (sin recidiva en últimos 5 años) el 41,3%. Presentó malignización un caso. Conclusión: La papilomatosis se caracteriza por ser una patología de curso impredecible, con probabilidad baja de malignizar y en la que la microcirugía láser carbónico ha supuesto una revolución con respecto a su tratamiento sintomático, porque aún no se ha descubierto el tratamiento curativo (AU)

Objectives: The study goal was to evaluate the efficacy of CO2 laser surgery in the treatment of laryngeal papillomatosis. We analysed several parameters such as gender, average age, relapse rate and viral serotype. Material and methods: A total of 26 diagnosed patients were included in this retrospective descriptive review. All of them were treated with CO2 laser for laryngeal papillomas between 1995 and 2010. Results: This pathology was more prevalent in males (65.5%), with a slight predominance of a single larynx localisation over multiple lesion locations. Human papillomavirus (HPV) DNA was detected in 75.8% of the cases; genotypes 6 and 11 prevailed. Of the patients in this review, 44.8% relapsed; the relapse average was 2–3 episodes per patient. A total of 20.7% of cases were in remission (no relapse in the last 2 months); 34.5%, clearing (no apparent relapse in the last 3 years); and 41.3% in the healing stage (without relapse in the last 5 years). There was only one case that showed malignancy. Conclusion: Papillomatosis is characterised as a pathology with an unpredictable course and with a low probability of malignancy. CO2 laser surgery has meant a revolution in symptomatic treatment, but there is presently no curative treatment (AU)

[Papillomas & laryngeal papillomatosis. Treatment with CO2 laser surgery. Our experience over 15 years]. / Papilomas y papilomatosis laríngea. Tratamiento con láser CO2. Nuestra experiencia en 15 años.

OBJECTIVES: The study goal was to evaluate the efficacy of CO2 laser surgery in the treatment of laryngeal papillomatosis. We analysed several parameters such as gender, average age, relapse rate and viral serotype. MATERIAL AND METHODS: A total of 26 diagnosed patients were included in this retrospective descriptive review. All of them were treated with CO2 laser for laryngeal papillomas between 1995 and 2010. RESULTS: This pathology was more prevalent in males (65.5%), with a slight predominance of a single larynx localisation over multiple lesion locations. Human papillomavirus (HPV) DNA was detected in 75.8% of the cases; genotypes 6 and 11 prevailed. Of the patients in this review, 44.8% relapsed; the relapse average was 2-3 episodes per patient. A total of 20.7% of cases were in remission (no relapse in the last 2 months); 34.5%, clearing (no apparent relapse in the last 3 years); and 41.3% in the healing stage (without relapse in the last 5 years). There was only one case that showed malignancy. CONCLUSION: Papillomatosis is characterised as a pathology with an unpredictable course and with a low probability of malignancy. CO2 laser surgery has meant a revolution in symptomatic treatment, but there is presently no curative treatment.