Highlights & Basics
- Laryngomalacia is a congenital abnormality of the larynx cartilage that predisposes to dynamic supraglottic collapse during the inspiratory phase of respiration, resulting in intermittent upper airway obstruction and stridor.
- Most common laryngeal anomaly and most frequent congenital cause of stridor in infants.
- Natural history is presentation in early infancy with maximal symptoms at 6 to 8 months before gradual improvement and spontaneous resolution within 12 to 24 months.
- Presents with inspiratory stridor. Some patients have upper airway obstruction with associated feeding difficulties. Frequently associated with GERD.
- Diagnosis is made by the clinical features and with flexible laryngeal endoscopy. Direct rigid laryngoscopy under anesthesia may also be required. Possibility of additional airway lesions should be considered.
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Citations
Olney DR, Greinwald JH Jr, Smith RJ, et al. Laryngomalacia and its treatment. Laryngoscope. 1999 Nov;109(11):1770-5.[Abstract]
Carter J, Rahbar R, Brigger M, et al. International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations. Int J Pediatr Otorhinolaryngol. 2016 Jul;86:256-61.[Abstract]
McCaffer C, Blackmore K, Flood LM. Laryngomalacia: is there an evidence base for management? J Laryngol Otol. 2017 Nov;131(11):946-54.[Abstract]
Yellon RF, Goldberg H. Update on gastroesophageal reflux disease in pediatric airway disorders. Am J Med. 2001 Dec 3;111(suppl 8A):78S-84S.[Abstract]
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35. Valera FC, Tamashiro E, de Araújo MM, et al. Evaluation of the efficacy of supraglottoplasty in obstructive sleep apnea syndrome associated with severe laryngomalacia. Arch Otolaryngol Head Neck Surg. 2006 May;132(5):489-93.[Abstract][Full Text]
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38. Lane RW, Weider DJ, Steinem C, et al. Laryngomalacia. A review and case report of surgical treatment with resolution of pectus excavatum. Arch Otolaryngol. 1984 Aug;110(8):546-51.[Abstract]
39. Seid AB, Park SM, Kearns MJ, et al. Laser division of the aryepiglottic folds for severe laryngomalacia. Int J Pediatr Otorhinolaryngol. 1985 Nov;10(2):153-8.[Abstract]
40. Zalzal GH, Anon JB, Cotton RT. Epiglottoplasty for the treatment of laryngomalacia. Ann Otol Rhinol Laryngol. 1987 Jan-Feb;96(1 Pt 1):72-6.[Abstract]
41. Senders CW, Navarrete EG. Laser supraglottoplasty for laryngomalacia: are specific anatomical defects more influential than associated anomalies on outcome? Int J Pediatr Otorhinolaryngol. 2001 Mar;57(3):235-44.[Abstract]
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43. Kelly SM, Gray SD. Unilateral endoscopic supraglottoplasty for severe laryngomalacia. Arch Otolaryngol Head Neck Surg. 1995 Dec;121(12):1351-4.[Abstract]
44. Froehlich P, Seid AB, Denoyelle F, et al. Discoordinate pharyngolaryngomalacia. Int J Pediatr Otorhinolaryngol. 1997 Feb 14;39(1):9-18.[Abstract]
45. Preciado D, Zalzal G. A systematic review of supraglottoplasty outcomes. Arch Otolaryngol Head Neck Surg. 2012 Aug;138(8):718-21.[Abstract]
46. Douglas CM, Shafi A, Higgins G, et al. Risk factors for failure of supraglottoplasty. Int J Pediatr Otorhinolaryngol. 2014 Sep;78(9):1485-8.[Abstract]
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49. Unal E, Oran B, Baysal T, et al. Pulmonary arterial pressure in infants with laryngomalacia. Int J Pediatr Otorhinolaryngol. 2006 Dec;70(12):2067-71.[Abstract]
