Achkar VNRE, et al. - Retrospective data and biopsies of 36 cases with juvenile laryngeal papillomatosis (LP) (JLP) and 56 with adult patients (ALP) were assessed and analyzed the histopathological characteristics of JLP in relation to severity (the Derkay score). They recorded the mean of the Derkay score in the JLP group, 10.97 whereas in Group ALP was 8.26. A more aggressive result was presented in the JLP group as compared to the adult group. They also noticed a correlation between the respiratory difficulty and tracheostomy and a higher Derkay score in the JLP group. A higher incidence of atypical mitosis and mitosis above the basal cells layer of the epithelium were demonstrated in the JLP samples microscopically and these properties were correlated with a higher Derkay index. There seemed a higher degree of LP severity in JLP.