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~/larynx-ppt/create_ppt.js

~/larynx-ppt/create_ppt.js

cat > /home/daytona/workspace/larynx-ppt/create_ppt.js << 'ENDOFSCRIPT' const pptxgen = require("pptxgenjs"); const pres = new pptxgen(); pres.layout = "LAYOUT_WIDE"; pres.title = "Benign Laryngeal Tumors: RRP & Hemangioma"; const C = { darkBg: "0D1B2A", midBg: "1B3A52", accent: "E8A838", accentAlt: "4ABFD4", white: "FFFFFF", lightGray: "E8EEF4", bodyText: "1E2D3D", subText: "4A6880", red: "D94F3D", }; function addTitleSlide(title, subtitle) { const s = pres.addSlide(); s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.darkBg } }); s.addShape(pres.ShapeType.rect, { x: 0, y: 5.8, w: 13.3, h: 0.12, fill: { color: C.accent } }); s.addShape(pres.ShapeType.ellipse, { x: 10.0, y: -1.2, w: 5, h: 5, fill: { color: C.midBg }, line: { color: C.midBg } }); s.addText(title, { x: 0.8, y: 1.8, w: 11.7, h: 1.8, fontSize: 40, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri" }); s.addText(subtitle, { x: 0.8, y: 3.7, w: 11.7, h: 0.9, fontSize: 20, color: C.accent, align: "center", fontFace: "Calibri" }); s.addText("For Specialist Clinicians | Otolaryngology – Head & Neck Surgery", { x: 0.8, y: 6.05, w: 11.7, h: 0.5, fontSize: 13, color: "AABCCC", align: "center", fontFace: "Calibri" }); } function sectionDivider(title, sub) { const s = pres.addSlide(); s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.midBg } }); s.addShape(pres.ShapeType.rect, { x: 0, y: 3.5, w: 0.3, h: 2.0, fill: { color: C.accent } }); s.addText(title, { x: 0.6, y: 2.5, w: 12.2, h: 1.3, fontSize: 42, bold: true, color: C.white, fontFace: "Calibri", valign: "middle" }); if (sub) s.addText(sub, { x: 0.6, y: 4.1, w: 12.2, h: 0.8, fontSize: 20, color: C.accentAlt, fontFace: "Calibri" }); } function contentSlide(heading, bullets, opts = {}) { const s = pres.addSlide(); const ac = opts.accent || C.accent; s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.lightGray } }); s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.22, h: 7.5, fill: { color: ac } }); s.addShape(pres.ShapeType.rect, { x: 0.22, y: 0, w: 13.08, h: 1.05, fill: { color: C.darkBg } }); 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"FFFFFF" : "EAF2F8" } } }))) ]; s.addTable(tableRows, { x: 0.35, y: 1.2, w: 12.6, colW: opts.colW, border: { color: "C0D0DC", pt: 0.5 } }); } // ─── SLIDES ──────────────────────────────────────────────────────────────── // 1: Title addTitleSlide("Benign Tumors of the Larynx", "Recurrent Respiratory Papillomatosis · Hemangioma of the Larynx"); // 2: Outline contentSlide("Presentation Outline", [ "PART I — Recurrent Respiratory Papillomatosis (RRP)", { text: "Definition, Epidemiology & Etiology", sub: true }, { text: "Pathology & HPV Subtypes", sub: true }, { text: "Clinical Features & Staging (Derkay Score)", sub: true }, { text: "Diagnosis", sub: true }, { text: "Surgical & Adjuvant Management", sub: true }, { text: "Complications & Prognosis", sub: true }, "PART II — Hemangioma of the Larynx", { text: "Definition, Types & Epidemiology", sub: true }, { text: "Pathogenesis & Molecular Biology", sub: true }, { text: "Clinical Features & Diagnosis", sub: true }, { text: "Management: Pediatric & Adult", sub: true }, "Comparison Table & Key Takeaways", ]); // 3: Section divider RRP sectionDivider("PART I", "Recurrent Respiratory Papillomatosis (RRP)"); // 4: RRP Definition & Epidemiology contentSlide("RRP: Definition & Epidemiology", [ "Most common benign laryngeal neoplasm: 84% of all benign laryngeal tumors (Jones et al.)", "Definition: Recurrent exophytic squamous papillomas of the aerodigestive tract caused by Human Papillomavirus (HPV)", "Two clinical forms:", { text: "Juvenile-onset RRP (JoRRP): First two decades of life; more aggressive course", sub: true }, { text: "Adult-onset RRP (AoRRP): After 3rd decade; generally less frequent recurrence", sub: true }, "Incidence: ~4.3 per 100,000 children; ~1.8 per 100,000 adults", "Predominant sites: Larynx (glottis most common), trachea, bronchi; pulmonary parenchyma involvement rare but severe", "Juvenile peak age: 2–4 years; Adult peak: 20–40 years", "Solitary papilloma (<1% of pulmonary neoplasms) vs. diffuse papillomatosis (laryngotracheal spread)", ]); // 5: Etiology & Transmission contentSlide("RRP: Etiology & Transmission", [ "Causative agent: HPV — subtypes 6 & 11 account for the majority of cases", "HPV subtype significance:", { text: "HPV-6: Less aggressive; lower recurrence rate", sub: true }, { text: "HPV-11: More aggressive; higher surgical frequency; greater risk of tracheopulmonary spread", sub: true }, { text: "HPV-16 & 18: Higher risk of malignant transformation — vigilant surveillance required", sub: true }, "Juvenile-onset transmission: Vertical — maternal condylomata acuminata during vaginal delivery", { text: "~1 in 400 at-risk children develop RRP; ~7 per 1,000 births to genitally-infected mothers", sub: true }, { text: "Cesarean section: NOT definitively protective against RRP — role remains controversial", sub: true }, "Adult-onset transmission: Presumed oral-genital contact", "Cofactors: GERD (acid disrupts mucosal barrier), immunosuppression, estrogen (↑HPV gene expression; I3C reduces HPV-induced proliferation by ~75% in mice)", ]); // 6: Pathology contentSlide("RRP: Pathology", [ "Gross: Exophytic, warty / grape-like polypoid masses arising most commonly from free edge of true vocal folds", "Histology (H&E):", { text: "Fibrovascular cores covered by hyperplastic squamous epithelium", sub: true }, { text: "Koilocytic change — perinuclear halo with nuclear atypia / wrinkling — pathognomonic of HPV", sub: true }, { text: "Contact endoscopy (150x): Koilocytes clearly identifiable in papilloma of larynx", sub: true }, "Endoscopic appearance:", { text: "White light: Exophytic, pale-pink lesions; subtle stippled vascularity (often misdiagnosed as reflux laryngitis)", sub: true }, { text: "Narrow-Band Imaging (NBI): 'Carpet variant' — prominent stippled vascularity; enables earlier detection of subtle disease", sub: true }, "HPV subtyping by PCR: Guides prognosis and surveillance intensity", "Malignant transformation: Rare overall (<1%); risk elevated with HPV-16/18, radiation history, immunosuppression", ]); // 7: Clinical Features contentSlide("RRP: Clinical Features", [ "Cardinal symptom: Hoarseness (most common; may be the only early symptom)", "Progression: Gradual dysphonia → progressive → aphonia if untreated", "Voice character localizes the lesion:", { text: "Aphonia / breathy / high-pitched cracking voice → glottic lesion", sub: true }, { text: "Low-pitched, coarse, fluttering voice → subglottic lesion", sub: true }, "Stridor: High-pitched inspiratory or biphasic (as airway obstruction worsens)", "Advanced: Tachypnea, accessory muscle use, neck hyperextension, cyanosis", "Other features: Chronic cough, recurrent pneumonia (pulmonary spread), failure to thrive, dysphagia", "Key differential clues:", { text: "No positional change in stridor (vs. laryngomalacia, vascular ring)", sub: true }, { text: "No feeding difficulties / allergic rhinitis / vocal abuse history (vs. nodules, GERD)", sub: true }, "Red flags: Respiratory distress, tachycardia, falling SpO₂ → urgent airway evaluation", ]); // 8: Staging contentSlide("RRP: Staging — Derkay Clinical Scoring System", [ "Most widely adopted staging tool (American Society of Pediatric Otolaryngology — ASPRH System)", "Anatomical subsites scored (0–3 for extent at each site):", { text: "0 = no disease; 1 = surface lesion; 2 = raised lesion; 3 = bulky lesion", sub: true }, { text: "Sites include: epiglottis, AE folds, arytenoids, false cords, true vocal cords, subglottis, trachea, bronchi, nasal cavity, nasopharynx, hypopharynx, esophagus", sub: true }, "Functional scores added:", { text: "Voice: 0 (normal) → 3 (aphonic)", sub: true }, { text: "Stridor: 0 (absent) → 3 (at rest)", sub: true }, { text: "Urgency of last surgery: 1 (elective) → 4 (emergency)", sub: true }, "Aggressive disease criteria:", { text: ">=4 surgical procedures per year", sub: true }, { text: "Tracheal or pulmonary involvement", sub: true }, { text: "Tracheotomy dependence", sub: true }, "Score used to monitor treatment response and disease progression over serial procedures", ]); // 9: Diagnosis contentSlide("RRP: Diagnosis", [ "Best preoperative tool: Flexible fiberoptic nasopharyngoscopy (office-based)", { text: "Sequential inspection: pharynx → hypopharynx → larynx → subglottis", sub: true }, { text: "Scopes as small as 1.8 mm available for neonates; video monitor recording for documentation", sub: true }, "NBI endoscopy: Stippled 'carpet variant' vascularity — earlier detection than white-light; prevents misdiagnosis as reflux laryngitis", "Direct laryngoscopy under GA: Required when outpatient exam is inadequate; also the operative approach", "Biopsy: Gold standard for histological confirmation; sent for HPV subtyping by PCR", "Contact endoscopy (150x): Demonstrates koilocytes — confirms HPV-induced epithelial change", "CT chest / neck: Indicated if HPV-11, 16, or 18 and any suspicion of tracheopulmonary extension", "Differential diagnosis to exclude:", { text: "Vocal fold nodules, vocal fold paralysis, subglottic stenosis, subglottic hemangioma, laryngeal carcinoma", sub: true }, ]); // 10: Surgical Management contentSlide("RRP: Surgical Management", [ "No cure — standard of care is serial surgical debulking", "Goals: Complete papilloma removal; preserve normal laryngeal structures; safe patent airway; optimal voice; maximize inter-procedure interval", "Critical principle: Accept residual disease rather than damage normal tissue — excessive scarring worsens outcomes", "Staged removal at anterior commissure: Prevents simultaneous raw surfaces → web / stenosis formation", "CO₂ Laser (10,600 nm): Most commonly used; 'no-touch' vaporization technique; precise; minimizes bleeding; couples to operating microscope; 250 µm spot size achievable", "KTP Laser (532 nm): In-office awake unsedated technique — blanches and ablates; good for glottic disease", "Powered Microdebrider (RPMI): Excellent for bulky disease; less thermal injury than laser; popular in pediatric cases", "Tracheotomy: Last resort only — disseminates virus to tracheal mucosa; predicts worse prognosis; used only for impending airway collapse", ]); // 11: Adjuvant Therapy twoColSlide( "RRP: Adjuvant Medical Therapies", "Primary Adjuvants", [ "Intralesional Cidofovir: Most studied adjuvant; CMV antiviral; injected at time of surgical debulking; reduces recurrence burden", "Bevacizumab (anti-VEGF): IV or intralesional; off-label; significant promise in aggressive/refractory RRP; reduces surgical frequency", "HPV Vaccine (Gardasil 9): Prophylactic vaccine; adjunctive role in active RRP — partial/complete responses reported; recommended for all eligible patients", "Interferon-alfa: Inhibits viral replication; older agent; significant side effects; disease often rebounds on cessation", ], "Secondary / Emerging", [ "Indole-3-carbinol (I3C): Inhibits estrogen metabolism; 70% response rate overall; better in adults than children; open-label data only", "Antireflux therapy (PPI/H2-blocker): Reduces mucosal inflammation; associated with fewer laryngeal webs; high-risk RRP patients benefit most", "Cimetidine (H2-antagonist): Immunomodulatory properties; small case series evidence only", "Celecoxib (COX-2 inhibitor): Mechanistic rationale; multi-institutional RCT showed NO significant therapeutic advantage", "Mumps vaccine (intralesional): Open-label moderate success; not reproducible across centers", ], { accent: C.red } ); // 12: Complications & Prognosis contentSlide("RRP: Complications & Prognosis", [ "Tracheopulmonary extension: ~1–5% of cases; HPV-11 highest risk; tracheotomy history + multiple procedures predispose", { text: "Presents as recurrent pneumonia, atelectasis, pulmonary nodules — carries significant mortality", sub: true }, "Tracheotomy dependence: High procedure count → increased tracheal seeding; strongly predicts worse prognosis", "Laryngeal stenosis / web formation: Repeated surgery at anterior commissure; aggressive scarring; prevents by staged approach", "Malignant transformation: <1% overall; significantly higher with HPV-16/18 or radiation history; mandates surveillance biopsies", "Spontaneous remission: Reported in some juvenile cases at puberty — hormonal influence postulated", "Quality of life impact: Chronic dysphonia, repeated OR visits, school/work absence, anxiety — psychosocial support important", "Favorable prognostic factors: HPV-6 subtype, adult-onset, low Derkay score, no tracheal involvement, no prior tracheotomy", "Poor prognostic factors: HPV-11, early juvenile onset, tracheotomy, long disease duration, immunosuppression", ]); // 13: Section divider Hemangioma sectionDivider("PART II", "Hemangioma of the Larynx"); // 14: Definition & Types contentSlide("Laryngeal Hemangioma: Definition & Types", [ "Definition: Benign vascular tumor arising from hematopoietic progenitor cells within the larynx", "Classified by age of onset and morphology:", { text: "Subglottic / Infantile hemangioma: Most common neoplasm of the pediatric airway; capillary type; undergoes involution", sub: true }, { text: "Adult laryngeal hemangioma: Usually supraglottic or at/above vocal fold level; cavernous type; does not involute", sub: true }, "Morphological types:", { text: "Capillary hemangioma: Small-caliber vessels; predominant pediatric type; proliferative then involuting", sub: true }, { text: "Cavernous hemangioma: Large-diameter vascular spaces; adult predominance; bluish discolored mass under thin mucosa", sub: true }, "Sex predilection: Female : Male = 2:1 for subglottic / infantile type", "Association: 60% of infants with hemangiomata in 'beard distribution' (preauricular, chin, mandibular, lower lip, neck) have a subglottic lesion", ]); // 15: Pathogenesis contentSlide("Laryngeal Hemangioma: Pathogenesis & Natural History", [ "Origin: Hematopoietic progenitor cells (possibly of placental origin) or local tissue stem cells, following genetic alterations", "Key molecular mediators of growth:", { text: "MMP-9 (matrix metalloproteinase-9) — promotes angiogenesis and extracellular matrix remodeling", sub: true }, { text: "VEGF (Vascular Endothelial Growth Factor) — main driver of neovascularization", sub: true }, { text: "b-FGF (basic Fibroblast Growth Factor) — stimulates endothelial proliferation", sub: true }, { text: "TGF-β (Transforming Growth Factor-beta) — regulates cellular growth signals", sub: true }, "Natural history — Infantile / Subglottic (three phases):", { text: "Proliferative phase: Rapid growth; birth to ~12 months of age; peak symptom severity", sub: true }, { text: "Plateau phase: Stabilization at ~12 months", sub: true }, { text: "Involution phase: Spontaneous regression expected by 18 months to 2 years of age", sub: true }, "Adult hemangioma: No involution; slow progression over years; hemorrhage risk — spontaneous or intraoperative", ]); // 16: Clinical Features Two-column twoColSlide( "Laryngeal Hemangioma: Clinical Features", "Pediatric / Subglottic", [ "Biphasic stridor — onset at ~6 weeks of age (85% present by 6 months)", "Progressive respiratory distress during proliferative phase; worsening with crying", "Soft, compressible subglottic swelling — typically LEFT-sided", "60% with 'beard distribution' facial hemangiomas have subglottic lesion", "PHACES syndrome (screen all cases): Posterior fossa malformations, facial Hemangioma, Arterial lesions (head/neck), Cardiac anomalies (coarctation of aorta), Eye abnormalities, Sternal cleft", "Spontaneous involution expected by 18–24 months", ], "Adult Laryngeal", [ "Hoarseness — dominant presenting symptom", "Symptoms may have been present for many years (stable course)", "Respiratory distress: NOT a feature (unlike pediatric type)", "Bluish discolored supraglottic or vocal fold mass on laryngoscopy", "Hemoptysis: Spontaneous or — more commonly — surgical complication", "Dysphagia: Occurs with large supraglottic extension", "Significant hemorrhage risk if incautiously biopsied", ], { accent: C.accentAlt } ); // 17: Diagnosis contentSlide("Laryngeal Hemangioma: Diagnosis", [ "High kV AP neck X-ray (Pediatric):", { text: "Classic: Unilateral subglottic soft-tissue mass — usually LEFT lateral wall; asymmetric narrowing", sub: true }, { text: "Distinguishes from croup: Croup shows symmetric 'steeple sign' subglottic narrowing", sub: true }, "Rigid bronchoscopy (Pediatric — gold standard):", { text: "CRITICAL: Do NOT intubate before visualizing — lesion compressed by tube → missed diagnosis", sub: true }, { text: "Findings: Vascular blush on vocal cord; rounded compressible vascular mass in subglottis (usually left)", sub: true }, { text: "Biopsy NOT required if typical location + typical age — avoids hemorrhage risk", sub: true }, { text: "Rare mimicker: ALK-positive histiocytic lesion — consider if atypical features", sub: true }, "PHACES workup (if facial hemangiomas): Echocardiography, MRI brain + angiography, ophthalmology, thyroid function", "MRI with gadolinium: T2 hyperintense; delineates extent; useful for large, atypical, or extensive lesions", "Adult: Flexible laryngoscopy → bluish vascular supraglottic/glottic mass; cautious biopsy only if diagnosis uncertain", ]); // 18: Management Pediatric contentSlide("Laryngeal Hemangioma: Management — Pediatric", [ "FIRST-LINE: Systemic Propranolol (non-selective β-blocker) — standard of care since 2008", { text: "Mechanism: Immediate vasoconstriction; ↓ VEGF/bFGF (medium-term); ↑ apoptosis of endothelial cells (long-term)", sub: true }, { text: "Dose: 1–3 mg/kg/day orally; inpatient initiation if <8 weeks age (risk of apnea/hypoglycemia); monitor HR, BP, BGL", sub: true }, { text: "Response: Dramatic — visible shrinkage within weeks; continue until ~12–18 months (involution phase)", sub: true }, "Alternative: Nadolol — once-daily; some evidence of better CNS safety profile vs. propranolol", "If β-blockers contraindicated:", { text: "IV or intralesional corticosteroids — inhibit growth in proliferative phase", sub: true }, "Surgical (refractory / failed medical management):", { text: "CO₂ laser vaporization: Biopsy first, then vaporize; may require 2 procedures; superior to old modalities", sub: true }, { text: "Open surgical excision via laryngofissure: For large obstructing lesions", sub: true }, { text: "Alpha-interferon: Historical — NOT first-line due to neurotoxicity risk in infants", sub: true }, "Tracheotomy: Airway rescue only; plan for decannulation once involution complete; avoid prolonged tracheotomy", ]); // 19: Management Adult contentSlide("Laryngeal Hemangioma: Management — Adult", [ "Conservative management preferred — no spontaneous involution; many lesions stable for years", "Observation: Reasonable if asymptomatic, not enlarging, and not compromising voice/airway", "Indications for active intervention:", { text: "Progressive enlargement involving additional laryngeal subsites (Bridger et al. criteria)", sub: true }, { text: "Significant / progressive hoarseness", sub: true }, { text: "Recurrent hemoptysis", sub: true }, { text: "Airway compromise (rare)", sub: true }, "Corticosteroid therapy (systemic or intralesional): Reduces lesion size; used when surgery is not immediately appropriate", "Radiotherapy: Effective; reserved for inaccessible or recurrent lesions; modern use limited due to morbidity", "Laser surgery:", { text: "CO₂ laser NOT ideal for cavernous hemangioma — vessel diameter exceeds CO₂ coagulating capacity; risk of hemorrhage", sub: true }, { text: "KTP or Nd:YAG laser: Better penetration and coagulating ability for large-caliber vessels", sub: true }, "Open resection: For extensive lesions; laryngofissure approach; blood product availability essential", "Propranolol: Emerging evidence; may be used as primary or adjunctive therapy in adult hemangiomas", ]); // 20: Comparison Table tableSlide( "RRP vs. Laryngeal Hemangioma: Comparison at a Glance", ["Feature", "RRP", "Laryngeal Hemangioma"], [ ["Etiology", "HPV (subtypes 6 & 11 most common)", "Vascular tumor — hematopoietic progenitors/stem cells"], ["Age of peak", "Juvenile: 2–4 yr; Adult: 20–40 yr", "Subglottic: <6 months; Adult: any age"], ["Sex predilection", "Equal (M = F)", "Female 2:1 (subglottic / infantile)"], ["Dominant site", "Glottis — true vocal folds", "Subglottis (pediatric); Supraglottis (adult)"], ["Key symptom", "Hoarseness, biphasic stridor", "Biphasic stridor (pediatric); hoarseness (adult)"], ["Natural history", "Recurrent; no spontaneous resolution", "Involution by 18 mo–2 yr (pediatric only)"], ["Histology", "Squamous papilloma; koilocytes", "Capillary or cavernous vascular channels"], ["Gold standard Dx", "Flexible laryngoscopy + biopsy + PCR", "Rigid bronchoscopy (no pre-intubation); MRI"], ["First-line Rx", "CO₂/KTP laser or Microdebrider", "Propranolol (pediatric); Conservative (adult)"], ["Key adjuvant", "Cidofovir / Bevacizumab / HPV vaccine", "Corticosteroids; CO₂ laser (refractory pediatric)"], ["Malignant risk", "Low (<1%); higher HPV-16/18", "Extremely rare"], ["Avoid", "Tracheotomy (seeds disease)", "Biopsy without preparation; CO₂ for cavernous"], ], { colW: [2.6, 5.0, 5.0], accent: C.accentAlt } ); // 21: Key Takeaways contentSlide("Key Takeaways for Specialist Practice", [ "RRP is the most common benign laryngeal neoplasm — always consider in any patient with chronic progressive hoarseness", "HPV-11 predicts aggressive disease with tracheopulmonary risk; HPV-16/18 requires malignant transformation surveillance", "Serial surgical debulking remains the mainstay — no cure; goal is reducing burden and prolonging inter-procedure intervals", "Avoid tracheotomy in RRP wherever possible — it seeds the trachea and predicts worse prognosis", "Stage the anterior commissure — never remove bilateral disease simultaneously to prevent laryngeal web", "Subglottic hemangioma: Propranolol is the modern standard of care; do NOT intubate before visualizing at bronchoscopy; rule out PHACES syndrome", "Adult laryngeal hemangioma: Observe if stable; CO₂ laser is NOT ideal for cavernous type — use KTP/Nd:YAG for better coagulation", "NBI endoscopy is a high-yield tool for detecting subtle RRP ('carpet variant') missed on white-light examination", "GERD exacerbates RRP — evaluate and treat reflux in all RRP patients; antireflux therapy reduces laryngeal webs", "HPV vaccination (Gardasil 9) should be offered to RRP patients and their eligible family members", ]); // 22: References contentSlide("Key References", [ "Cummings Otolaryngology: Head & Neck Surgery, 7th Ed. — Chapters 60, 206 & 208", "K.J. Lee's Essential Otolaryngology, 11th Ed. — Subglottic Hemangioma, pp. 1028–1029", "Scott-Brown's Otorhinolaryngology Head & Neck Surgery, Vol 1 & 2 — Papilloma & Laser Management", "Robbins & Cotran: Pathologic Basis of Disease, 10th Ed. — Squamous Papilloma & Papillomatosis", "Fishman's Pulmonary Diseases and Disorders, 2-Vol Set — Solitary Papilloma/Papillomatosis", "Derkay CS & Wiatrak B. Recurrent respiratory papillomatosis: a review. Laryngoscope 2008;118:1236–47", "Leaute-Labreze C, et al. Propranolol for severe infantile hemangiomas. NEJM 2008;358:2649–51", "Zur KB, et al. Primary bevacizumab therapy for aggressive juvenile RRP. Int J Pediatr Otorhinolaryngol 2015", "Bridger GP, et al. Hemangioma of the adult larynx. Arch Otolaryngol Head Neck Surg 1970;92:493", "Derkay CS. Task force on recurrent respiratory papillomas: a preliminary report. Arch Otolaryngol HNS 1995", ]); pres.writeFile({ fileName: "/home/daytona/workspace/larynx-ppt/RRP_Hemangioma_Larynx.pptx" }) .then(() => console.log("SUCCESS: Presentation created.")) .catch(e => { console.error("ERROR:", e); process.exit(1); }); ENDOFSCRIPT echo "Script written OK"

cd /home/daytona/workspace/larynx-ppt && node create_ppt.js

ls -lh /home/daytona/workspace/larynx-ppt/RRP_Hemangioma_Larynx.pptx