Flexible nasolaryngoscopy showing an extensive papillomas involving epiglottis, false vocal cords and true vocal cords. The latter resulted in progressive worsening of voice needing surgical intervention. Florid and further growth of these papillomas can result in airway obstruction and difficulty in breathing. These lesions can be ablated or removed using CO2 laser, pulse dye laser and microdebrider. The lesions are known to be recurrent and can involve lower airway passage in long-standing cases.