World Library  
Flag as Inappropriate
Email this Article


Article Id: WHEBN0003316895
Reproduction Date:

Title: Laryngomalacia  
Author: World Heritage Encyclopedia
Language: English
Subject: Fetal warfarin syndrome, Congenital pulmonary airway malformation, Relapsing polychondritis, Nasal septal hematoma, Otorhinolaryngology
Publisher: World Heritage Encyclopedia


Omega shaped epiglottis, seen in laryngomalacia
Classification and external resources
ICD-10 Q31.5
ICD-9-CM 748.3
OMIM 150280
DiseasesDB 29421
eMedicine ped/1280

Laryngomalacia (literally, "soft larynx") is the most common cause of stridor in infancy, in which the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction. It can also be seen in older patients, especially those with neuromuscular conditions resulting in weakness of the muscles of the throat. However, the infantile form is much more common. Laryngomalacia is one of the most common laryngeal congenital disease in infancy and public education about the signs and symptoms of the disease is lacking.


  • Presentation 1
  • Causes 2
  • Diagnosis 3
  • Prognosis 4
  • Treatment 5
  • References 6


In infantile laryngomalacia, the supraglottic larynx (the part above the vocal cords) is tightly curled, with a short band holding the cartilage shield in the front (the epiglottis) tightly to the mobile cartilage in the back of the larynx (the arytenoids). These bands are known as the aryepiglottic folds. The shortened aryepiglottic folds cause the epiglottis to be curled on itself. This is the well known "omega shaped" epiglottis in laryngomalacia. Another common finding of Laryngomalacia involves the posterior or back part of the larynx, where the arytenoid cartilages or the mucosa/ tissue over the arytenoid cartilages can collapse into the airway and cause airway obstruction.

Laryngomalacia results in partial airway obstruction, most commonly causing a characteristic high-pitched squeaking noise on inhalation (inspiratory stridor). Some infants have feeding difficulties related to this problem. Rarely, children will have significant life threatening airway obstruction. The vast majority, however, will only have stridor without other more serious symptoms such as dyspnea (difficulty breathing).


Although laryngomalacia is not associated with a specific gene, it is evidence that some cases may be inherited.[1][2] Relaxation or a lack of muscle tone in the upper airway may be a factor. It is often worse when the infant is on his or her back, because the floppy tissues can fall over the airway opening more easily in this position.[3]


The physician will ask some questions about the baby’s health problems and may recommend a flexible laryngoscopy to further evaluate the infant's condition.[3]


Laryngomalacia becomes symptomatic after the first few months of life( 2-3 months), and the stridor may get louder over the first year, as the child moves air more vigorously. Most of the cases resolve spontaneously and less than 15% of the cases will need surgical intervention. Parents need to be supported and educated the condition.


Time is the only treatment necessary in more than 90% of infant cases.[4] In other cases, surgery may be necessary.[5][6][7] Most commonly, this involves cutting the aryepiglottic folds to let the supraglottic airway spring open. Trimming of the arytenoid cartilages or the mucosa/ tissue over the arytenoid cartilages can also be performed as part of the Supraglottoplasty. Suprglottoplasty can be performed bilaterally (on both the left and right sides at the same time), or be staged where only one side is operated on at at time.[8] Treatment of gastroesophageal reflux disease can also help in the treatment of laryngomalacia, since gastric contents can cause the back part of the larynx to swell and collapse even further into the airway. In some cases, a temporary tracheostomy may be necessary.


  1. ^ Shulman JB, Hollister DW, Thibeault DW, Krugman ME (1976). "Familial laryngomalacia: a case report". Laryngoscope 86 (1): 84–91.  
  2. ^ Shohat M, Sivan Y, Taub E, Davidson S (1992). "Autosomal dominant congenital laryngomalacia". Am. J. Med. Genet. 42 (6): 813–4.  
  3. ^ a b "Laryngomalacia – The Children's Hospital of Philadelphia". The Children's hospital of Philadelphia. Retrieved 31 August 2012. 
  4. ^ Bye Michael R MD (September 13, 2007). "Laryngomalacia: Treatment & Medication". eMedicine from WebMD. 
  5. ^ Holinger LD, Konior RJ (1989). "Surgical management of severe laryngomalacia". Laryngoscope 99 (2): 136–42.  
  6. ^ Zalzal GH (1989). "Stridor and airway compromise". Pediatr. Clin. North Am. 36 (6): 1389–402.  
  7. ^ Solomons NB, Prescott CA (1987). "Laryngomalacia. A review and the surgical management for severe cases". Int. J. Pediatr. Otorhinolaryngol. 13 (1): 31–9.  
  8. ^ Walner, D.L. (2015). "Supraglottoplasty in Infants: A Staged Approach". Annals of Otology, Rhinology and Laryngology.  
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.