Recurrent Respiratory Papillomatosis

gardasil_logo_tcm1908-197175Adjuvant therapies I have found useful in diminishing the recurrence of this frustrating disease.  Use the CO2 laser.  Have patients eat green leafy vegetables (Indole-3-carbinols) modulates estrogen metabolism and 1/3 of patients respond.  Inject Cidofovir after resection.  Place on Celebrex (Cox 2 inhibitor) modulates the over expression of epidermal growth factor by inhibiting cyclooxygenase-2 and prostaglandin E2.  Give Gardisil (6,11,16,18).  Consider injecting Avastin (Bevacizumab) recombinant monoclonal antibody against vascular endothelial growth factor.  And, of couse prayer!