How would you manage recurrent laryngeal papillomatosis requiring multiple resections of lesions with pathology never revealing any degree of dysplasia?

I am not aware of any study of radiotherapy for laryngeal papillomatosis. It is not included in the usual indications for radiotherapy of benign disease. Thus, no radiotherapy. An alternative to repeated surgeries may be photodynamic laser (Motz and Hillel, PMID 27242951).

There are limited data but some exist.

If no other options and the patient understands the risks, it may be worth exploring.

Byhardt and Almagro, PMID 3282424

GALLOWAY et al., PMID 13826182