Recurrent Respiratory Papilloma

Recurrent respiratory papillomatosis (RRP) is a condition caused by a relatively common virus, the human papilloma virus (HPV).

Recurrent respiratory papillomatosis (RRP), also known as papilloma or laryngeal papilloma, is a condition caused by a relatively common virus, the human papilloma virus (HPV).

An infection with HPV causes lumpy growths to form on the vocal cords. These growths are not cancerous but, in their extreme form, can cause some difficulty with breathing. Typically, the growths are small and cause a mild or moderate dysphonia (hoarseness).

A distinguishing aspect of this disease is the tendency for the papilloma to recur after surgical procedures to remove them.

Recurrent Respiratory Papillomatosis Symptoms

The most common symptom of RRP is a voice that is persistently hoarse, weak, low in pitch, breathy or strained. Often dysphonia can occur as well.

Recurrent Respiratory Papillomatosis Diagnosis

RRP is typically diagnosed by an ear, nose and throat doctor performing an examination of the larynx. Most of the time, an ENT doctor or a speech-language pathologist performs a laryngoscopy or a videostroboscopy to make the diagnosis.

Recurrent Respiratory Papillomatosis Treatment

While there is no current cure for patients with RRP, there are several treatment strategies that effectively control this disease.

The mainstay of therapy for RRP involves using a laser to remove the wart-like growths. If the number of growths is small, or if most of it has been removed already in the operating room, we are able to use either the C02 laser or the pulsed-KTP laser in the clinic. We use our transnasal telescope after the administration of topical anesthesia only. This has the advantage of being speedy, safe, well tolerated, and avoids general anesthesia.

Cidofovir is an antiviral medication that was not designed specifically for the human papilloma virus, but there is good evidence supporting its use in some cases of RRP. This medication tends not to cure the papilloma, but rather extends the time between future treatments.

Because these lesions tend to recur (thus the name), it can be frustrating for the patient. As our strategies for managing this condition become less invasive, the disruption to our patient's life is minimized.

Care and Treatment

Diagnostic Tools

Laryngeal Stroboscopy

Laryngoscopy

Perceptual, Acoustic, and Aerodynamic Voice Evaluation

Upper Airway and Esophageal Endoscopy

Providers

Insurance

Insurance Accepted

This chart is a list of the most common health insurance plans we accept. This list is subject to change. Please check your individual plan to confirm their participation and the coverage allowed.

Due to the different physician groups and hospitals within the Wake Forest Baptist system, physician services and hospital services are billed separately. Please remember that health insurance coverage varies, so some services may not be covered.

If you don’t see your plan or you have questions, please call our Customer Service Center at 877-938-7497. We will do our best to work with you and your plan.

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC -Not Contracted, very low to no volume for facility and/or CHC

Wake Forest Baptist Health Managed Care/MA Contracts - January2022

AETNA CONNECTED ACA/Exchange: Accepted at all locations

AETNA (PPO & HMO): Accepted at all locations

AETNA MEDICARE: Accepted at all locations

AETNA WHOLE HEALTH: Accepted at all locations

ALIGNMENT HEALTHCARE MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, Davie, LMC, CHC and Wilkes (not applicable to services provided at High Point)

AMBETTER OF NC: Accepted at all locations

AMERIHEALTH CARITAS NEXT ACA/Exchange: Accepted at all locations

APEX MEDICARE ADVANTAGE: Accepted at all locations

BCBSNC (PPO & HMO): Accepted at all locations

BCBS HIGH PERFORMANCE (NATIONAL NETWORK): Accepted at all locations

BLUE LOCAL WITH ATRIUM HEALTH: Accepted at all locations

BLUE MEDICARE: Accepted at all locations

BLUE VALUE: Accepted at all locations

CAROLINA BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

CIGNA: Accepted at all locations

CIGNA BEHAVIORAL HEALTH: Accepted at NCBH and High Point (not applicable to services provided at Davie, LMC, CHC and Wilkes)

CIGNA HEALTHSPRING MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, Davie, LMC, CHC and High Point (not applicable to services provided at Wilkes)

CIGNA LIFESOURCE (TRANSPLANTS): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

COVENTRY/WELLPATH: Accepted at all locations

CRESCENT PPO (ASHEVILLE): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

DEVOTED HEALTH: Accepted at all locations

DIRECT NET: Accepted at WFUHS, NCBH, Davie, LMC, Wilkes and High Point (not contracted, very low to no volume for CHC)

FIRST HEALTH (COVENTRY): Accepted at all locations

FIRSTCAROLINACARE (PINEHURST, NC): Accepted at NCBH (not contracted, very low to no volume for WFUHS, Davie, LMC, CHC, Wilkes and High Point)

GATEWAY HEALTH ALLIANCE (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

GOLDEN RULE INS (UNITED): Accepted at all locations

HEALTHGRAM (formerly PRIMARY PHYSICIAN CARE): Accepted at WFUHS, NCBH and LMC (not contracted, very low to no volume for Davie, CHC, Wilkes and High Point)

HEALTHTEAM ADVANTAGE: Accepted at all locations

HUMANA CHOICECARE: Accepted at all locations

HUMANA MEDICARE ADVANTAGE: Accepted at all locations

LIBERTY ADVANTAGE (MEDICARE ADVANTAGE): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

MAGELLAN (BEHAVIORAL HEALTH): Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

MEDCOST: Accepted at all locations

MEDCOST ULTRA: Accepted at WFUHS, NCBH, Davie, LMC, Wilkes and High Point (not applicable at CHC)

OPTUMHEALTH (TRANSPLANTS - APPLICABLE TO NCBH/WFUHS ONLY): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

PREFERRED CARE OF VA INC: Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

SOUTHERN HEALTH SVCS (COVENTRY-PPO ONLY): Accepted at WFUHS, NCBH, Davie and CHC (not contracted, very low to no volume for LMC, Wilkes and High Point)

TWIN COUNTY (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

UNITED BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH, CHC and High Point (not applicable to services provided at Davie, LMC and Wilkes)

UNITED BEHAVIORAL HEALTH INTENSIVE OUTPATIENT PROGRAM (WFUHS ONLY): Accepted at WFUHS (not applicable for services provided at NCBH, Davie, LMC, CHC, Wilkes and High Point)

UNITED HEALTHCARE: Accepted at all locations

UNITED HEALTHCARE ESSENTIALS ACA/EXCHANGE: Accepted at all locations

UNITED HEALTHCARE MEDICARE: Accepted at all locations

VA CCN: Accepted at all locations

WELLCARE: Accepted at all locations

WELLPATH (COVENTRY): Accepted at all locations

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC - Not Contracted, very low to no volume for facility and/or CHC

Referring Physicians

At Atrium Health Wake Forest Baptist we understand the importance of referrals. Our Physician Liaisons partner with referring physicians in our community and beyond to provide information on our physicians and clinical services. Full list of new physicians.

Contact the Physician Liaisons