What is Recurrent Respiratory Papillomatosis?
Recurrent respiratory papillomatosis (RRP) is a chronic condition in which benign but persistent wart-like growths — called papillomas — develop in the airway, most commonly on the vocal cords. RRP is caused by the human papillomavirus (HPV), most often subtypes 6 and 11, and can affect both children (juvenile-onset RRP) and adults (adult-onset RRP). While the growths are benign, they can cause significant voice changes, breathing difficulty, and in severe cases, airway compromise.
What makes RRP particularly challenging is its tendency to recur. Even after surgical removal, papillomas frequently return — sometimes within weeks — making ongoing management a central part of living with this condition. For many patients, RRP is not a problem that is solved once, but one that requires a trusted, experienced specialist for the long term.
Common Symptoms of RRP
- Hoarseness or progressive change in voice quality
- A weak, breathy, or rough voice
- Noisy breathing or stridor in more severe cases
- Shortness of breath or difficulty breathing with exertion
Diagnosis & Treatment
RRP requires a specialist who understands not just how to remove papillomas, but how to do so with precision — preserving as much healthy vocal cord tissue as possible while being appropriately aggressive about disease control. Dr. Benjamin Rafii brings the subspecialty laryngologic expertise this delicate balance demands, combining careful surgical judgment with the most advanced treatment options available.
Surgical debulking — typically performed using laser techniques — has long been the cornerstone of RRP management. When disease is frequent or aggressive, adjuvant therapies may be recommended, including Avastin (bevacizumab). Most recently, Papzimeos (zopapogene imadenovec-drba) — the first and only FDA-approved therapy for adult RRP — has marked a landmark advance in treatment, working by activating the body's immune system to fight the HPV infection at the root of the problem. Additional medications targeting the immune system are currently under active investigation and show promise for the future of RRP treatment.
Related Conditions: Hoarseness & Voice Disorders | Airway & Breathing Disorders | Laryngeal Cancer & Precancerous Conditions
Related Treatments: Vocal Cord Laser Surgery | Transoral Laser Microsurgery | Vocal Cord Biopsy & Tissue Sampling
Related Services: Comprehensive Voice Evaluation | Vocal Cord & Voice Surgery
If you or a loved one has been diagnosed with RRP, Dr. Rafii and his team are here to help. Contact us today to schedule a consultation at The Laryngology & Voice Center of Beverly Hills — same- and next-day appointments are available.