TASK-FORCE ON RECURRENT RESPIRATORY PAPILLOMAS - A PRELIMINARY-REPORT

Objective: To obtain pilot data about the incidence, need for surgical intervention, and demographics of recurrent respiratory papillomas in the United States. Design: Otolaryngologists were surveyed using a qu estionnaire with structured and open-ended questions. Participants: On e thousand board-certified otolaryngologists practicing in the United States as of January 1, 1993, through a random mailing list provided b y the American Academy of Otolaryngology-Head and Neck Surgery and all active US members of the American Society of Pediatric Otolaryngology and the American Bronchoesophagological Association. A total of 1346 questionnaires were distributed. Main Outcome Measures: Physician's re sponses to questions about their current patient load of children and adults with recurrent respiratory papillomas, their surgical and anest hetic management of the disease, and their clinical experiences with r isk factors for developing recurrent respiratory papillomas. Results: Projected totals for recurrent respiratory papillomas among children w ere 2354 new cases (95% confidence interval [CI], 1448 to 3260) and 59 70 active cases (95% CI, 3465 to 8474), requiring 16 597 surgical proc edures (95% CI, 6938 to 26 255) at a cost of $109 million (95% CI, $45 to $172 million) for March 1, 1993 to March 31, 1994. Projected total s for adult recurrent respiratory papillomas were 3623 new cases (95% CI, 2359 to 4887) and 9015 active cases (95% CI, 6435 to 11 591) requi ring 9284 surgical procedures (95% CI, 6003 to 12 565) at a cost of $4 2 million (95% CI, $27 to $59 million) for March 1, 1993 to March 31,1 994. The incidence of recurrent respiratory papillomas among children is estimated at 4.3 per 100 000; among adults, 1.8 per 100 000. The ca rbon dioxide laser was favored by 92% of respondents. No consensus was reached on the role for cesarean section. Forty-six percent of respon dents favored the use of a laser-safe endotracheal tube for anesthetic management. Conclusion: A registry of patients with recurrent respira tory papillomas would benefit future research protocols and provide lo ng-term follow-up of patients.