The main objectives of surgery are: ① to relieve airway obstruction, maintain respiratory ventilation, and reduce airway resistance. ②Protect the laryngeal mucosa and institutional integrity, reduce the damage to the vocal cord tissue, and avoid the formation of vocal cord adhesions laryngeal webbing and other medical secondary injuries. ③Prolong the recurrence time and reduce the number of surgeries. Most scholars believe that intermittent high-frequency ventilation under general anesthesia and direct laryngoscopic extraction of the tumor is the most effective treatment method. The common surgical techniques: microincision and suction transfer technique, low temperature plasma radiofrequency ablation technique, laser technique, etc. In the treatment of children with multiple recurrent respiratory papillomas, multiple surgical procedures are performed when necessary, but tracheotomy is still one of the important treatments for children with difficult respiratory distress or multiple recurrences in a short period of time. Regardless of the surgical technique, it should be fully understood that complete removal of the tumor may not be possible, and sometimes a small amount of diseased tissue is allowed to remain. The microdissection and suction technique is the main surgical resection technique for pediatric laryngeal papilloma, and its special suction and cutter head can precisely remove the diseased tissue with less damage to the normal mucosa; the advantage of radiofrequency ablation with low-temperature plasma knife is that it does not require protection from endotracheal intubation, no bleeding, no pressure, and is also more widely used. Tracheotomy: When the laryngeal obstruction is severe or when it is difficult to relieve the child’s respiratory distress through endolaryngologic surgery, tracheotomy is the only way to maintain airway patency. In our department, tracheotomy is performed for some recurrent laryngeal papilloma, and the results of long-term clinical follow-up studies show that the number of operations performed by tracheotomy is significantly reduced compared with that of children without tracheotomy, and the operation interval is significantly prolonged, which can reduce vocal cord injury, adhesions and various complications caused by general anesthesia, and can significantly reduce the economic burden of parents. Therefore, we believe that tracheotomy is still a proven method. However, post-tracheotomy care is crucial. Surgical complications: mainly include posterior stenosis, anterior conjoined laryngeal web formation and stenosis, in addition to surgical complications such as subglottic stenosis, tracheal stenosis, and in severe cases, pneumothorax and intra-airway burning, which will lead to severe tracheal and pulmonary injury. For children with multiple recurrences more than four times per year, a close surgical plan needs to be developed and surgery should be performed regularly according to the changes in the disease. For children with longer intervals between recurrences, regular outpatient review of laryngoscopy is needed to determine the extent of the lesion and the timing of surgery. This disease has the possibility of multiple recurrence. There are many reasons for recurrence, including the tendency of the tumor to proliferate itself, the extent of viral infection that is greater than the extent of tumor growth, and the difficulty of complete removal of the tumor due to the effect of bleeding during laryngoscopic surgery. The mechanism of recurrence is currently described in 2 ways, one is implantation and the other is activation of the inactive virus. The interval of tumor recurrence varies from child to child. Generally, they all recur within 2-6 months after surgery, but the interval of recurrence gradually lengthens as the number of surgeries increases. The tendency of recurrence decreases after puberty, and some of them can disappear by themselves.