Laryngomalacia Flashcards
What is laryngomalacia?
It refers to a condition in which the supraglottic larynx is structured in a way that results in partial airway obstruction
This leads to a chronic stridor during inspiration, where the larynx flops across the airway as the infant breathes
Describe the two structural changes in laryngomalacia
The aryepiglottic folds are shortened which pulls on the epiglottis, resulting in an omega shape
The tissue surrounding the supraglottic larynx is softer with reduced tone, which means that it can flop across the airway. This happens particularly during inspiration, as the air moving through the larynx to the lungs pulls the floppy tissue across the airway to partially occlude it.
How many aryepiglottic folds are there? Where are they located?
Two
The are at the entrance of the larynx, running between the epiglottis and the arytenoid cartilages, on either side of the airway
What is the role of the aryepiglottic folds?
To constrict the opening of the airway to prevent food or fluids entering the larynx and trachea.
What patient age group tends to be affected by laryngomalacia?
Infants
Peak = 6 months
What is the main clinical feature of laryngomalacia?
Inspiratory stridor
What is the main clinical feature of laryngomalacia?
Inspiratory stridor
What is stridor?
It is defined as a harsh whistling sound caused by air being forced through an obstruction of the upper airway
What are the two characteristic features of the stridor associated with laryngomalacia?
Intermittent
Worsening upon feeding, upset, lying on their back or during upper respiratory tract infections
What clinical feature is not associated with laryngomalacia?
Respiratory distress
How is laryngomalacia usually managed? Why?
In most cases, it usually self resolves with maturation and growth of the larynx
This is because the larynx is then able to support itself and prevent it flopping over the airway
How can we supportively manage laryngomalacia?
Tracheostomy
What is a tracheostomy? How does this treat laryngomalacia?
It involves the insertion of a tube through the neck into the trachea
This allows air to bypass the larynx
How can we surgically manage laryngomalacia?
Supraglottoplasty
What is supraglottoplasty?
It involves alteration and reshaping of the tissues of the supraglottic larynx
