Studies of Etiology of Laryngeal Papilloma and an Autogenous Laryngeal Papilloma Vaccine

Abstract

1. Electron microscopic studies have failed to demonstrate virus particles in papillomas of four patients with laryngeal papilloma and one patient from whom the entire base of the papilloma was evulsed and excised from the tracheal wall.

2. No growth was obtained at the site of inoculation of the larynx of three female Rhesus monkeys whose true and false cords were inoculated unilaterally with 0.5 ml of a suspension made from papilloma removed from two children and one adult.

3. It was not possible to duplicate work reported previously which had indicated the presence of a species-specific virus capable of producing growth of tissue cultures with regrowth after blind serial tissue culture passes.

4. Blood samples were collected before and after vaccine therapy in patients with laryngeal papillomas so that in case a virus was isolated, the viral agent could be used as the antigen in a serological reaction; since the virus could not be isolated, there could be no serological evaluation of vaccine therapy.

5. The preparation and administration of an autogenous laryngeal papilloma vaccine is described, with the results of this therapy as used in 51 patients.

6. Clinical evaluation showed that 28, or 55 per cent, were improved; 13, or 25 per cent, were considered unchanged; and three, or six per cent, deteriorated. Inadequate information was obtained in seven, or 14 per cent.

7. The annual operation rate as calculated for 37 patients who had adequate data before and after operation showed that the annual operation rate decreased in 29 patients (78 per cent), did not change in three patients (eight per cent), and increased slightly in five patients (13 per cent). The annual operation rate before vaccine therapy was 4.00; after vaccine therapy was 1.88, an average of 2.12 operations per year.