Laryngomalacia
What is laryngomalacia?
Laryngomalacia
is a congenital abnormality of the larynx and is the result of a flaccidity
(floppiness) of the larynx (voice box) and surrounding tissue. This floppiness causes a narrowing of
the child’s airway which produces noisy breathing (squeaky or low
pitched) called stridor.
What is stridor?
Stridor is
the sound produced by turbulent airflow through a narrowed area in the
respiratory tract. Laryngomalacia
is the most frequent cause of stridor in children. Other causes of stridor include
congenital anomalies of the respiratory tract, infectious conditions of the
respiratory tract, vocal cord paralysis, trauma and tumors causing airway
narrowing.
What does the larynx do?
The larynx
functions as a passage for breathing, allows for voice communication (voice
box) and as a protective valve to close off the airway while swallowing.
What are the signs and symptoms of
laryngomalacia?
The
characteristic sign of laryngomalacia is a low pitched or squeaky intermittent
sound (stridor) when the baby breathes in.
This sound usually is louder when the child is crying, feeding or on
back. It will also worsen when the child
has a cold. It is usually noticed in the first few weeks of life and may worsen
over the first few months of life.
Some children will have inspiratory retractions (caving in of their
chest between their ribs). Many
children with laryngomalacia will also have symptoms of gastroesophageal reflux
(which may include spitting up).
How is stridor evaluated?
Any child
experiencing stridor should be medically evaluated. Once a detailed history is obtained the
child will be examined. To assist
in the evaluation, a fibroptic laryngoscopy is often preformed. A fibroptic laryngoscopy involves passing
a very thin tube (that has a light and telescope within it) through the
child’s nose to examine the child’s larynx and upper airway
anatomy. Often the diagnosis
can be made based on this examination.
Some types of stridor will require further imaging studies or
examination of the airway under general anesthesia.
How is laryngomalacia treated?
Many
infants with laryngomalacia will require no special treatment. They will be monitored to ensure normal
weight gain, oxygenation and development.
The symptoms will slowly improve over time and most children are free
from stridor by 1 year of age.
Babies who are having any gastroesophogeal reflux symptoms or worsening
stridor may be started on some oral medicine to help with the reflux which may
improve the laryngomalacia. In severe cases (weight gain, feeding or breathing
are impaired) the child may require surgical intervention or hospitalization.
If you have any questions or concerns please call our
office.
203-245-0496