[Question #4014] Oral HPV

32 months ago
I am a 65 yo man and  have been diagnosed with a papilloma on my soft palate. The ENT wants to remove it under general anesthesia, he refers to it as a wart. My question is, the growth is flat on my palate and is causing no problems. Is surgical removal recomended? Is this contagious?
I had a CT of my throat and all was clear.
Thanks,
John
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
Welcome to the forum and thanks for your question.

Unfortunately, while STD experts manage and work to prevent genital warts and HPV infections, including oral, we have little experience treating them. Were you to have come to my STD clinic, we would have referred you to otolaryngology (ENT specilist) for treatment. Your ENT doctor undoubtedly has far more experience with this than I do. It indeed is my understanding that surgery is usually the treatment used, but I cannot say whether that is supported by research (e.g. comparing people treated with surgical and nonsurgical methods) or just practice experience. The best approach also may vary widely from one patient to the next, based on the exact location of the wart(s), whether cancer is suspected, and other factors. (The normal CT probably was to make sure that if cancer is involved, it had not spread regionally.)

Is it contagious? First, perhaps it isn't caused by HPV. If it is, probably it could be spread to partners through oral sex. Kissing rarely transmits HPV, but I cannot say that it wouldn't happen. (But definitely not casual or social kissing -- only sexual kissing might risk transmission to partners.) If you have a regular, ongoing partner, you can assume s/he has been repeatedly exposed already and likely infected; but the vast majority of HPV infections, especially in the mouth, never cause warts or other symptoms and are cleared by the immune system.

Bottom line:  Continue to work with your ENT doctor or clinic. If uncertain about their knowledge or advice, consider asking for a second opinion.

Sorry I don't have conclusive answers, but I hope these comments are helpful.

HHH, MD
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32 months ago
I've had two bouts of bronchitis over the last two winters, could the oral HPV infection be the cause or contribute to the bronchitis? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
No, not at all. HPV causes no health problems of any kind except those caused by HPV itself at the site of infection, i.e warts, cancer, etc.---
32 months ago
Final question.....once the lesion has been removed and biopsied, if it is benign, would the HPV vaccine help in preventing recurrence?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
No. The vaccine has no effect on existing HPV infections or preventing their recurrence. It only prevents new infections upon first exposure.

As you know, that ends this thread, having had two follow-up questions and replies. My final advice is to completely ignore this going forward. Probably surgeries similar to yours, for oral warts and related lesions, have been going on for 100 years or more. During most of those years, medical science knew nothing of HPV and its potential transmission risks, but patients did just fine. You are not likely to transmit HPV to anyone and probably have not done so up til now; and your problem most likely is cured entirely.

I hope the discussion has been helpful. Best wishes.
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