Laryngomalacia

What is Laryngomalacia?

Laryngomalacia is a condition, typically in infants, in which the cartilage at the top of the voice box collapses inward during inhalation. 

Causes

Laryngomalacia is caused by underdevelopment of the cartilage of the upper larynx. Instead of becoming stiff, the cartilage remains floppy and unstable, allowing it to flop into the airway. Although laryngomalacia might be inherited in some cases, the underlying cause for the condition is not known.  

Symptoms

The chief symptom of laryngomalacia is a high-pitched squeaking noise at inhalation. This noise is known as “stridor,” from a Latin word meaning squeak or screech. The noise might be more noticeable when the infant is agitated; eating; exercising; or lying on her back.

Also, an infant with laryngomalacia might have trouble eating or gaining weight. 

Gastroesophageal reflux, which often accompanies laryngomalacia, can make the condition worse by causing swelling and further collapse of the airway. The infant might also have apnea, when breathing stops momentarily.

Laryngomalacia is usually not life-threatening, but sometimes intervention is needed to keep the airway open.

Treatment

Often, the infant will grow out of the condition; most of the time, it is gone by the time the child reaches 18 to 20 months. However, in as many as 20 percent of cases surgery might be necessary to alleviate severe symptoms. 

During a procedure called supraglottoplasty, extra tissue at the top of the larynx is trimmed after the airway is examined using a flexible tube with a light on the end.

The infant typically stays in the hospital a day or two for observation, to make sure breathing is normal.

While symptoms might not disappear entirely, the procedure should alleviate apnea, improve swallowing and allow the infant to start gaining weight.

Resources

Coping with Laryngomalacia Inc.: copingwithlm.org