Laryngeal papillomas are benign epithelial tumors that are caused by infection with the human papillomavirus (HPV). Papillomas can occur at any age; they occur frequently in children under 10 years of age, but in many cases they disappear after the patient has reached adolescence. They most commonly affect the larynx and upper respiratory tract of children, resulting in hoarseness, stridor, obstruction of the airway, and asphyxiation if left untreated. The leading cause of HPV infection in children is infection from the birth canal or the blood of the infected mother.
Papillomas often recur and can spread to the hypolaryngeal vestibules, the epiglottis, and occasionally the trachea and lungs; this may also lead to head and neck cancers. Because of the growth of the papillomas in the narrow pediatric airway, severe laryngeal obstruction may occur. Many children are treated as outpatients and require numerous procedures throughout their childhood to remove the tumors once or twice a month as they reappear. Some children with severe airway obstruction may even need a tracheotomy.