Our FAQs have been answered by Dr. Brian Wiatrak, M.D.
How did I get RRP?
RRP is caused by a virus; Human Papilloma Virus (HPV). There are over a hundred different types of HPV. The type that causes RRP is usually HPV types 6 and 11. These types of HPV can also infect the female reproductive tract, primarily the cervix, and children who are born to mothers who may have an HPV infection at the time, MAY transmit the virus to the respiratory tract of the baby. This is the most common explanation.
Why don’t other people have it?
Nobody knows this answer for sure. Obviously, if a baby is born to a mother without HPV infection in her cervical area, then the baby won’t get RRP. However, many babies born to mothers with HPV infection still may not get RRP. It is theorized that there may be a deficiency in the immune system of some children who make them more susceptible to HPV infection. Therefore, it seems that a baby may need to have a specific problem with their immune system responsible for defending against HPV AND there needs to be an exposure to the HPV virus in an infected mother when the baby is born.
Will it go away?
In many cases, as time goes by, often by the time of adolescence, the disease may go away, or become “quiescent” or quiet. Later in life, it may come back. This may happen at times of stress, other medical illnesses that may affect the immune system or if taking drugs, such as chemotherapy that can affect the immune system. In rare cases, some women who had RRP as a child and then had it go away, suffered a recurrence when they became pregnant. Fortunately, this is rare.
What happens during surgery?
During surgery, the papillomas are removed surgically while the patient is put to sleep with general anesthesia. There are different ways that have been proven to be effective in removing the papillomas. The most common techniques are using a laser (C02 or KTP usually) or an instrument called a microdebrider which suctions the tissue into a small tube that has a rotating blade inside that cuts and vacuums away the tissue. Both work well.
Why can’t I just breathe out of my nose instead of my throat?
When you breathe through your nose OR your mouth, the air goes down into the same place; the larynx (voice box where the vocal cords are) and then into the trachea. The papillomas involve the larynx and trachea so whether you breathe through your nose our mouth, if you have RRP, the obstruction occurs in the larynx and/or the trachea.
Why does my voice change?
The most common place for papillomas to grow in cases for RRP, is in the larynx (voice box) on the vocal cords. The vocal cords need to have a very smooth surface to allow normal vibration that allows the creation of a normal voice. If papillomas grow on the vocal cords, they can’t vibrate normally and the quality of the voice will be hoarse. In severe cases, there may be no voice at all until the papillomas are removed.
Do other people have RRP?
Yes; nobody knows exactly how many in the united states have RRP but, estimates are that about 5000 kids in the USA are affected with RRP at any one time. Some of these kids have RRP throughout their childhood and still have it as an adult. Some people develop RRP when they are adults.
Dr. Wiatrak is a pediatric ENT who serves as Chief of Pediatric Otolaryngology at Children’s Hospital of Alabama. He is involved with research regarding Recurring Respiratory Papillomavirus, and has presented his work in numerous publications and at meetings both domestic and international. He graduated from the University of Michigan Medical School in 1984, completed his internship and residency at the University of Cincinnati Hospital, and did a fellowship at Children’s Hospital in Cincinnati. He was board certified in otolaryngology in 1989.