Ihilov Clinic rightfully holds leading positions not only in Israel but also worldwide. By turning to Ihilov, patients can expect modern treatment in the largest public hospital in Israel, which has about 60 specialized departments, including a specialized department of otolaryngology and head and neck pathology, where the most qualified medical assistance is provided. The use of unique equipment and advanced technologies allows for minimally invasive surgical interventions that exclude undesirable consequences, making the treatment received here as effective as possible.
About the Disease
Laryngeal papillomatosis, also known as recurrent respiratory papillomatosis (RRP) or papillomatosis of the vocal cords, is a rare disease in which benign tumours (papillomas) form along the airway-digestive tract. The disease can lead to narrowing of the airways, which may cause voice changes or airway obstruction.
Types of laryngeal papillomatosis:
- juvenile laryngeal papillomatosis;
- adult laryngeal papillomatosis.
The mode of transmission in adolescence is closely related to vertical transmission during childbirth, while in adults, the mode of transmission is oral sex. However, studies have shown that other factors must be involved in the infection, as the presence of HPV alone on the mucous membrane does not necessarily cause the disease.
The prognosis for these patients is excellent, as laryngeal papilloma is a benign formation. However, it can have potentially fatal consequences if airway obstruction is a symptom, as well as a low risk of malignant transformation. Also, due to the high recurrence rate of the condition, most patients require multiple interventions, which increases the risk of postoperative complications.
Treatment Methods for Laryngeal Papillomatosis
Currently, there is no "cure" for laryngeal papillomatosis. The goals of treatment are to eliminate airway obstruction, reduce the number of disease recurrences, prevent the spread of the process, and restore audio function.
Surgical Treatment
Suspended microlaryngoscopy with laser removal is the gold standard, preferably using a CO2 laser (10,600 nm), with potassium-titanyl-phosphate (KTP) laser, pulsed dye laser with a wavelength of 585 nm, or argon laser also being used. At the physician's discretion, microdebriders, cold instruments, and endomicrosurgery are also applied.
In situations with airway obstruction, endotracheal intubation with a flexible bronchoscope or videolaryngoscope is performed first to attempt to avoid tracheostomy. Most laryngeal papillomas are easily displaced and manipulated, as they do not invade deep tissues. Tracheostomy is applied in exceptional cases when it is absolutely necessary to ensure airway patency, as it creates a transitional zone and predisposes to further spread of the disease.
Adjuvant Treatment
Criteria for adjuvant therapy include more than 4 surgical interventions within 1 year, rapid regrowth of the papilloma, airway obstruction, and/or distal multifocal spread of the disease. Options include the use of cidofovir, photodynamic therapy, bevacizumab, interferon, indole-3-carbinol, and proton pump inhibitors.
Preventive Measures
In addition to adjuvant therapy, it is also important to take preventive measures, such as using proton pump inhibitors. Controlling chronic exposure to gastric acid with proton pump inhibitors can help avoid metaplastic changes in the epithelium that may lead to the spread of papillomas.
Patients should also adhere to a gentle voice regimen, treat accompanying gastrointestinal pathologies (reflux esophagitis), and inflammatory diseases of the respiratory tract, ear, nose, and throat.
Diagnostic Methods for the Disease
Diagnosis at the Israeli Ihilov Clinic follows a pre-agreed scheme and takes no more than 3-4 days. The examination usually consists of three key stages, including a consultation with the attending physician, laboratory and instrumental studies, and a medical council.
Consultation with the Attending Physician
Immediately upon arrival at the clinic, the patient meets with the attending physician. The doctor will ask the patient about symptoms and review the medical history, then conduct a thorough examination of the head and neck. To make an accurate diagnosis and assess the patient's overall condition, some types of tests will be ordered.
Laboratory and Instrumental Studies
Depending on the physician's findings, the patient may be recommended:
- A laryngeal videostroboscopy procedure, for which a flexible and/or rigid endoscope attached to a video monitor and light source is used. This allows for a complete assessment of laryngeal function and vibration.
- Autofluorescence examination for a clear assessment of the boundaries of tumour growth and detection of hidden papilloma foci.
- Direct laryngoscopy or microlaryngoscopy allows the physician to fully examine the vocal cords with high magnification. The procedure is performed under general anesthesia. During the procedure, the physician may take tissue samples for biopsy.
- Molecular examination of the biopsy using PCR hybridization methods and in situ.
Medical Council
Upon readiness of the research results, the attending physician gathers a council consisting of physicians from related specialties. A collegial approach allows for a more detailed examination of the clinical case and consideration of all nuances and features of the disease course, as well as avoiding medical errors. After careful assessment, the physicians develop a therapeutic protocol and set a date for the start of treatment.
How Much Does Treatment Cost in Israel
The cost of treatment is determined individually and depends on the complexity of the clinical case. The final price is announced after the therapeutic protocol is approved.
The preliminary cost can be learned in advance. Leave your contact details in any of the available feedback forms or call the phone number indicated on the website. Medical support specialists will answer all your questions and prepare an individual estimate of expenses for medical services.
Advantages of Treatment at Ihilov Medical Center
The main reasons why patients prefer Ihilov Clinic:
- The opportunity to be treated by specialists with international training.
- The presence of a unique laboratory performing all types of analyses.
- Unique methods of intraoperative examination.
- State-of-the-art equipment and continuous implementation of innovative technologies.
- World-class services and amenities that are affordable and meet international standards.
- Positive reviews from patients who have already undergone treatment at the clinic.
If you or your loved ones have signs of the disease and you want to undergo treatment in Israel or receive a consultation from an Israeli doctor, contact our call center. A medical consultant will help you choose a doctor and establish direct contact with them.