Respiratory Papilloma

A respiratory papilloma (pap-pill-LO-ma) is a wart-like growth or tumor on the surface of the larynx (voice box). Respiratory papillomas are caused by the human papilloma virus (HPV). They’re usually benign (non-cancerous). These growths can lead to vocal cord damage and airway problems. 

Because the virus is in the tissue, respiratory papillomas tend to reoccur even after they are removed. This is called recurrent respiratory papillomatosis (RRP).  

Most cases of respiratory papilloma occur in children, who typically start showing symptoms at age 3 or 4. Adults usually develop this condition at age 40+. 

Signs or Symptoms

The most common symptom is progressive hoarseness. Additional symptoms include:

  • Hoarse, rough cough
  • Increased vocal effort
  • Breathing problems, if the lesions grow large enough to interfere with the airway
  • Feeling as if there is a lump in the throat
  • Ear pain


The University of Michigan Vocal Health Center team will ask you about your symptoms and medical history, and then do a thorough head and neck examination. During this process, we will also assess your vocal quality, efficiency and speaking technique. 

Depending upon our findings, we may need to do one of two procedures:

  • Laryngeal videostroboscopy procedure — We use a flexible and/or rigid endoscope attached to a video monitor and a light source. This allows us to fully evaluate laryngeal function and vibration.
  • Direct laryngoscopy or microlaryngoscopy — This procedure lets the physician fully examine the vocal folds with high magnification. The procedure is done under general anesthesia. During the procedure, the physician may obtain tissue samples for biopsy or remove a mass or tumor. A biopsy is a test that checks for inflammation or cancer cells. 


We remove respiratory papillomas using traditional surgery or carbon dioxide laser surgery. Severe cases can also be treated with chemotherapy. 

Respiratory papillomas can be removed using traditional surgery or carbon dioxide laser surgery. Because these tumors often come back, the patient often needs to have further surgeries.

Make an Appointment

Schedule an appointment by calling us at (734) 936-8051.