Tracheotomy as a predictor of remission and demise for juvenile-onset recurrent respiratory papillomatosis

Abstract

Backgroud

The pros and cons of tracheotomy, as a classic treatment of juvenile-onset recurrent respiratory papillomatosis (JORRP), have gradually been recognized, but the exact impact of tracheotomy on remission and demise is not clear.

Objectives

To investigate the predicting influence of tracheotomy on prognosis for JORRP.

Material and methods

Three hundred forty two patients with JORRP treated in Beijing Tongren Hospital were retrospectively reviewed. The clinical characteristics and prognosis parameters were compared in the group of tracheotomy and non-tracheotomy.

Results

The rate of tracheotomy was 24.6% (84/342). Among these patients, 68 (81.0%) developed the tracheal papillomatosis. The onset age of RRP occurred earlier in tracheostomized group, and patients performed tracheotomy needed a greater number of surgeries and developed distal spread more easily (p < .05). The remission rate was significantly lower (35.1 vs. 53.7%) and the mortality higher (13.1 vs. 1.2%) in patients with tracheotomy than non-tracheotomy. Tracheotomy decreased odds of remission (OR = 0.48; 95%CI: 0.28–0.83) and increased odds of demise (OR = 11.98; 95%CI: 3.21–44.65).

Conclusions

The age at diagnosis, the surgical frequency and the medical level of hospital are important factors affecting the occurrence of tracheotomy. Patients who had undergone tracheotomy are prone to possess the low remission rate and high mortality.

Chinese Abstract

背景：气管切开术, 作为青少年呼吸道乳头瘤病（JORRP） 发病的经典治疗方法, 利弊已逐渐被认识, 但气管切开术对缓解和死亡的确切影响尚不清楚。

目的：探讨气管切开术对JORRP预后的预测影响。

材料与方法：对北京同仁医院收治的342例JORRP患者进行了回顾性检查。比较气管切开组与非气管切开组的临床特征和预后参数。

结果：气管切开率为24.6%（84/342）。在这些患者中, 68 名 (81%) 患气管乳头状瘤病。气管切开组 RRP 发病年龄较早, 接受气管切开术的患者需要更多的手术并且更容易发生远端扩散（p < .05）。比较气管切开术患者和非气管切开术患者, 缓解率明显较低（35.1% vs. 53.7%）, 死亡率较高（13.1%）vs. 1.2%)。气管切开术降低了缓解几率（OR ¼ 0.48；95%CI：0.28–0.83）并增加了死亡几率（OR ¼ 11.98；95%CI：3.21–44.65）。

结论：诊断时年龄、手术频率和医院医疗水平是影响进行气管切开术的重要因素。接受过气管切开术的患者易发生低缓解率和高死亡率。

Keywords:

• Juvenile onset recurrent respiratory papillomatosis
• tracheotomy
• surgical interval
• predictor
• prognosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Table 1. Number of reasons for tracheotomy performed in patients.

Additional information

Funding

This work was supported by the [Pediatric special project of pediatric subject collaborative development center of Beijing Municipal Hospital Administration] under Grant [number XTCX201823]; and [Beijing Administration of Traditional Chinese Medicine] under Grant [number JJ-2020-17].