Respiratory - Laryngomalacia

Question 1

What is laryngomalacia?

Answer 1

Supraglottic larynx has reduced tone which flops over the airway causing obstruction

Causes chronic stridor when the larynx flops across the airway as the infant breathes in

Question 2

What are the structural changes in laryngomalacia?

Answer 2

Aryepiglottic folds are shortened

This pulls on the epiglottis and changes the shape to a characteristic omega shape

Question 3

What causes stridor in laryngomalacia?

Answer 3

Tissue surround supraglottic larynx is softer and has less tone in laryngomalacia

This causes the tissue to flop across the airway

Particularly during inspiration as air moving through, larynx pulls tissue across to partially occlude it

Question 4

How does laryngomalacia present?

Answer 4

Infants, peaking at 6 months
- Intermittent stridor
- Prominent stridor when feeding, upset, lying on back or during URTIs
- Feeding difficulties

Question 5

How does laryngomalacia progress?

Answer 5

As the larynx matures and grows it is better able to support itself

This prevents the larynx flopping over the airway

Question 6

What may be necessary in very severe laryngomalacia?

Answer 6

Tracheostomy

Surgery may be an option to alter laryngeal tissue