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bevacizumb_utility_in_rrp [2014/03/18 20:44] (current)
bziolko created
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 +Raul M. Cruz and Krzysztof Izdebski (USA)
  
 +**Bevacizumb utility in RRP**
 +
 +Recurrent respiratory papillomas (RRP) is a devastating disorder, especially in a performing vocal professional because consecutive laser excisions pose risks of extensive scarring and webbing. The risks of post-operative sequela rise exponentially with anterior location of papilloma clusters. Therefore, any additional or adjuvant treatments that can potentially reduce repeated operations, or prevent aggressive recurrence of disease are more than welcome. Application of bevacizumab (AvastinĀ®), fits these criteria. Consequently, we describe the outcome of adjuvant intra-lesion bevacizumab injection, in addition to laser debulking of papilloma clusters of the vocal folds in a professional performing voice user.  Objective assessment was done using HSDI and subsequent analysis of the mucosal wave with kymography, area FFT analysis and red color analysis. Results obtained at 37 months (January, 2014) after last surgery showed not only no recurrence of papilloma, but minimal vibratory asymmetry of mucosal wave between vocal folds, resulting in a significant restoration of voice function for this professional performing singer. Moreover, we discuss the accuracy of clinical assessment of mucosal wave characteristic and mapping of the lesions improved significantly with the use of HSDI, kymography, area FFT analysis and red color analysis over the traditional laryngovideo-stroboscopic exam.
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