Laryngomalacia

Question 1

What is Laryngomalacia?

Answer 1

• Laryngomalacia is a condition where the Supraglottic airway is structured in a way that causes a partial airway obstruction. This leads to a stridor on inhalation as the larynx flops across the airway when the infant breathes in.

Question 2

What are the structural changes in Laryngomalacia?

Answer 2

• There are two aryepiglottic folds at the entrance of the larynx which run between the epiglottis and the arytenoid cartilages
• The function of the aryepiglottic folds is to constrict the opening of the airway to prevent food or fluids entering the larynx and trachea
• In laryngomalacia the aryepiglottic folds are shortened which pulls on the epiglottis and changes shape to form an omega
• The tissue surrounding the supraglottic larynx is softer and has less tone in laryngomalacia meaning it can flop and obstruct the airway particularly in inspiration

Question 3

How does Laryngomalacia present?

Answer 3

-Laryngomalacia occurs in infants, and it peaks at 6 months of age.
- It presents with inspiratory stridor
- Seen when feeding, upset, lying on their back/ respiratory tract infections
- Causes difficulties with feeding but rarely complete airway obstruction

Question 4

What is the Disease course and Managment?

Answer 4

• Typically, the problem resolves by itself as the larynx matures and grows preventing it from flopping on itself.
  -Usually, no interventions are required
• Rarely a tracheostomy may be necessary, or surgery is required to alter the tissue in the larynx