Multiple Laryngeal Papillomatosis
Dr. Medhat Shams, MD

A 66 years old male (Egyptian) patient, working as a labour, presented with acute stridor, dysphonic since 8 years, the patient gave a history of previous laryngeal surgery, he underwent a microlaryngosurgery in 1999 and the biopsy showed chronic laryngitis. Fiberoptic examination of the larynx revealed a large whitish cauliflower glottic mass crossing the midline to reach the right side. CT. scan as below. Clinically cancer larynx was suspected. Patient was prepared for direct laryngscopy and biopsy with a trancheostomy consent. Debulking of the mass, incomplete excision using CO2 laser was done and the specimen sent for studies. Patient was extubated easily and stayed in HDU with no respiratory distress, histopathology result showed multiple laryngeal papillomatosis, patient refused any further surgical procedure with the possibility of tracheosyomy because of his job, so he was discharged with instruction to comeback in case of any respiratory distress. Three months later, patient came in severe distress, here the decision was taken for tracheostomy and repeated complete excision of the mass was done on 3 stages. Patient stayed four months in the hospital, when CT scanning and examination of the larynx under general anesthesia showed clear larynx with almost normal mucosa, closure of the traechtomy tube, the decanulation done, and patient was discharged, to be followed up in the clinic.