Candela Laser Corporation proposes to develop a cost-effective, atraumatic pulsed dye laser treatment for patients with recurrent respiratory papillomatosis (RRP). RRP is caused by the human papillomavirus (HPV), and is characterized by recurrent, nonmalignant, proliferative lesions of the larynx. Patients with RRP typically undergo numerous microsurgical procedures to remove laryngeal papilloma threatening airway patency. The standard surgical technique involves CO2 laser vaporization of laryngeal epithelium affected by the lesions, and requires general anesthesia. In the proposed work it will be shown that the pulsed dye laser can be used to induce regression of laryngeal papilloma in an atraumatic manner. It has already been shown that the pulsed dye laser is effective in clearing HPV lesions of the skin (verrucae). The pulsed dye laser radiation is fiber compatible, and may be delivered using a flexible intranasal laryngoscope and local anesthesia. Potential advantages of the pulsed dye laser treatment over CO2 laser surgery include (1) reduced morbidity, especially a lower risk of laryngeal scarring, (2) lower cost, (3) reduced technical difficulty, and (4) reduced risk of viral dissemination or transmission.
