MEDCIAL MANAGEMENT:

Medical management has been investigated over the last 20 years with some varying success.  These medical therapies include Interferons, photodynamic treatment, anti-virals like Acyclovir, BCG which is the TB vaccine and intralesional injections e.g. with the mumps vaccine.  An acid suppressant (PPI) must always be used. 

COMPLICATIONS:

In severe cases the patient may die from airway obstruction.  Scarring, especially of the anterior larynx can occur with repeated surgery.  The papilloma disease can extend into the lungs (especially if a tracheostomy is done). The papilloma can also progress rarely into squamous carcinoma.  Hoarseness which was the presenting symptom, may also be permanent.

PREVENTION:

Recently the HPV vaccine (Gardasil) has been strongly recommended in especially pre-teen girls.  This may eradicate the disease in years to come.