Inclusion Criteria:

1. Immunocompetent children ages 1-12 with symptomatic JORRP requiring operative
intervention

2. Children who have historically required at least four surgeries in the year preceding
enrollment to treat laryngeal JORRP

Exclusion Criteria:

1. Children who have required fewer than four procedures to treat laryngeal JORRP in the
year prior to enrollment.

2. Children who are currently receiving adjuvant therapies for JORRP including
cidofovir, interferon, indole-3-carbinol or Hsp-E7.

3. Caregivers who are non-English speaking as the PVRQOL instrument has been validated
only in the English language.

4. Children whose families do not sign an informed consent to enter into the study.

5. Children whose families anticipate discontinuing care at a participating institution
during the study period