Combined C02-Laser and Alfa Recombinant Interferon Treatment in Five Children with Juvenile Laryngeal Papillomatosis

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Abstract
Juvenile laryngeal papillomatosis is a rare and benign tumoral disease of childhood characterized by numerous relapses despite complete resection. The ENT treatment of choice is to vaporize the papillomas with a C02 laser. Since the discovery of a viral etiology (Human Papilloma Virus), resection has been followed by medical attemps to control the disease by using various antiviral treatments. Among the latter, alfa interferon has proved effective during the first six months of treatment. In this article, we report on five cases of refractory juvenile laryngeal papillomatosis treated by excision (C02 laser in four children, surgical resections in one child) and a-r IFN 1.5 x 105 U/kg daily. With this strategy, three of the five children are currently disease-free for periods ranging from 22 to 68 months. This series includes one remarkable observation of one child who responded only to double doses of a-r IFN, after initial failure at conventional doses. This therapeutic scheme reduced the frequency of relapses in a fourth child. In only one child the treatment did fail to modify the natural course of the disease.

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