A Pedunculated Uvula Papilloma

Papilloma of The Uvula

A Pedunculated Uvula Papilloma

In patients seen in the photo above photograph throat had complaints of gastroesophageal reflux-like complaints such as coughing and a feeling of stuck in the throat. It was observed that the patient's complaints disappeared after surgical removal of this area. Histopathological examination revealed viral papilloma.

Human papillomavirus (HPV) is a sexually transmitted virus that has spread more and more in recent years and has more than 300 different subtypes. The incidence has increased gradually in the last 10 years. The most common subgroups of this virus are those that make lesions called "warts" or "papillomas"; There are also subgroups of tissues that cause cancer. Carcinogenic HPV viruses are also subdivided into three groups as "high risk", "possible high risk" and "low risk" (high risk types >> types 16, 18, 31, 33, 35, 39, 45). high risk types >> types 26, 53, 66 and low risk types type 6, 11, 40, 42, 43, 44, 54). Generally, most of the recognized lesions are benign. In recent years, this virus is not only through sexual intercourse; it has become clear that it can be transmitted by direct mucosal contact (using a condom alone is not enough!) and showing that the virus can be found without lesions in the mouth, the studies on the production of vaccines and the spread of the vaccine have led to the acceleration of the public awareness studies on antivirus.

Different Information about HPV Virus

Human papillomavirus (HPV), known as a virus causing sexual warts and cervical cancer in women, is increasingly recognized as an infection of the entire mouth, including the tongue base and tonsils.

• HPV is the most commonly transmitted sexually transmitted virus in the US
• There are about 200 different types of HPV that do not cause cancer, many of which are harmless. HPV strains are associated with oral cancers, cervical, anal and penile cancers
• You may have unintentionally contacted HPV because the virus does not produce any signs or symptoms that you often notice, and the immune response to clear it is not a process to be aware of (the host's immune status and mucosal characteristics may cause the virus to be present before any lesions occur). .
• In the US, approximately 12,000 people between the ages of 15-24 become HPV-infected every day. According to the ongoing NHANES study, about 26 million Americans have oral HPV infection on any given day. Approximately 2600 of these are HPV16. The vast majority of individuals will naturally cleanse the virus through their own immune responses and will never know they have been exposed or possessed.
• If you test positive for HPV, there is no way to know when HPV has been infected or who gave it to you. A person can have HPV for years without detection even after it has become a serious condition like cancer. In the majority of infected people, even if there is a high-risk version of HPV known to cause cancer, the cancer will not develop.
• A positive test for HPV infection does not mean that you or your partner have sexual intercourse outside the relationship. It is thought that long-term inactivity or stagnant process can last for decades. These mean the time intervals you will test as negative.
• Sexual partners who have been together for a while tend to share all kinds of sexual infections. HPV viral infections are also shared sexually. Even if it does not have any signs or symptoms; It means that a person who has a positive sexual partner for HPV is likely to have HPV. As with most Americans, the immune system will clear it in less than 2 years.
• Condoms can reduce the chance of infection during sexual intercourse. However, HPV can affect areas not covered by condoms; condoms are not completely protective against HPV

Symptoms of HPV Infection in the Mouth

Many patients with HPV viruses in the mouth have no symptoms. Fluffy pink or whitish, smooth-shaped or rough, painless lesions such as cauliflower may develop into the mouth from the surface. HPV benign lesions called "papilloma" and taste buds on your tongue "Papilla" can be mistaken by patients because of the similarity of name and appearance. Taste buds close to the root of the tongue can be as round as lentil grains and flat round, especially them, can be mixed with paillomas. When oral cancers rarely occur, the following early symptoms of oral cancers may occur:

• Swallowing problem
• Fixed ears
• Spitting blood
• Unexplained weight loss
• Enlarged lymph nodes
• Continuous sore throat
• Masses growing in the neck
• Hoarseness

None of the above symptoms is sepepic to HPV infection.

Risk Factors for Oral HPV Infection

Risk factors for oral HPV include:

• Oral sexual activity increases the risk, especially if you have multiple sexual partners. If your sexual partner is 20 or more people, your chances of getting an oral HPV infection may be as high as 20 percent.
• Smoking is a risk factor. Different adverse effects of smoking on the oral mucosa facilitate both cervicalization and HPV infection
• Alcohol consumption is a risk factor. If you're both smoking and drinking, you're at an even higher risk ...
• Open-mouth kissing is also a risk factor, but further research is needed to determine if it increases your risk of oral HPV.
• Men have a higher risk of oral HPV diagnosis than women.
• Age is a risk factor for oropharyngeal cancer. It is more common in older adults because it takes years to develop.

Oral HPV Infection Treatment

Many types of oral HPV disappear without causing any health problems. When oral warts occur due to HPV, surgical, chemical removal of the warts is preferred. Warts can be difficult to treat with topical treatments (warts can be difficult to reach). For the treatment of wart or papilloma in the mouth can use any of the following methods:

• surgical intervention
• cryotherapy with warts frozen
• Interferon alpha-2B (Intron A, Roferon-A) injection

If oropharyngeal cancer develops, treatment options are available. HPV positive oropharyngeal cancers have better outcomes and less relapse after treatment than HPV negative cancers. Treatment of oropharyngeal cancer includes radiation therapy, surgery, chemotherapy, or a combination thereof.

Ways to Prevent HPV Infection in the Mouth

Most medical and dental organizations do not recommend screening for oral HPV. Lifestyle changes are some of the easiest ways to help prevent HPV. Here are some tips on prevention:
• Limitation of the number of sexual partners (monogamy is the best way to protect)
• Ask sex partners if they have been tested for sexually transmitted diseases recently.
• Avoid oral sex if there is a suspicious lesion
• Use a condom when you have sex.
• Ask your dentist to search your mouth for anything abnormal, especially if you experience frequent oral sex during your six-month examination.
• Once a month, it is a habit to find out if there is any abnormality.
• If you have had a mouth-to-mouth relationship or have an open-mouth kiss, then use antiseptic mouthwashes.

• It is recommended that the HPV vaccination program be started before sexual intercourse, according to current publications. The Centers for Disease Control and Prevention (CDC) recommend that all girls aged 11-12 receive the HPV vaccine to protect against cervical cancer, and women aged 13-26 should be vaccinated when they do not receive the HPV vaccine. CDC also recommends HPV vaccine for all boys aged 11-12 and in men between 13-21 years of age who did not receive the vaccine when they were younger. All men can receive vaccinations up to 26 years of age. The HPV vaccine is also recommended for all men who have had sexual intercourse with malformed men and males.

Photos of Uvula Papilloma

Below is the image of a similar case of "uvula papilloma" before and after surgical excision.

Uvula Papilloma
Uvula Papilloma

Uvula papilloma wart oral
In the photograph above, the papilloma attached upwards with the pedicle is seen at the tip of the uvula.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47