Recurrent Respiratory Papillomatosis: Clinical course and psychosocial aspects

San Giorgi, M., 2017, [Groningen]: University of Groningen. 182 p.

Research output: ThesisThesis fully internal (DIV)

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  • Title and contents

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  • Chapter 1

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  • Chapter 2

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  • Chapter 3.1

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  • Chapter 3.2

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  • Chapter 4

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  • Chapter 5

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  • Chapter 6

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  • Chapter 7

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  • Chapter 8

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  • Chapter 9

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  • Summary

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  • Samenvatting

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  • Dankwoord

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  • Curriculum vitae

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  • Complete thesis

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  • Propositions

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Recurrent Respiratory Papillomatosis (RRP) is a rare disease, which is characterized by wart-like growth throughout the airway. It causes vocal problems and airway problems. Patients depend on repetitive surgical interventions. This thesis showed that RRP starts around the ages of 7, 35 and 64 years. Furthermore we observed that the clinical course worsens if the age of onset is lower. Human Papillomavirus (HPV) 11 patients have a significant worse clinical course than HPV6 patients when young at the start of the disease. The longer the patient has the disease, the less surgeries are needed.
A potential therapeutic is the HPV vaccine Gardasil®. We demonstrated that seroreactivity rose significantly after a therapeutic vaccination. The number of needed surgeries diminished.
Gastro-esophageal reflux disease (GERD) was said to worsen the clinical course of RRP. In a systematic review we showed there is no prove for this.
Due to the unpredictable and severe course of RRP, it was thought that patients could experience severe psychosocial problems. We showed that RRP patients have more depressive symptoms than on average; that they have more voice problems and a lower esteem of their health. Patients can be screened for distress and the causes of distress with the ‘Distress Thermometer and Problem List’ . We showed that a revised version of this tool is valid, practical and appreciated instrument. Furthermore we showed that the current English (online) information for patients is of poor quality.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
Award date5-Jul-2017
Place of Publication[Groningen]
Print ISBNs978-90-367-9814-3
Electronic ISBNs978-90-367-9813-6
Publication statusPublished - 2017

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