Laryngomalacia (congenital laryngeal stridor)

Laryngomalacia (also called congenital laryngeal stridor) is a congenital (present at birth) anomaly of the larynx (voice box) that causes stridor (noisy breathing). There are many causes of stridor; laryngomalacia is the most common one in infants and is due to an inward collapse of the floppy, soft upper structures of the larynx. Sixty percent of infants born with laryngomalacia have symptoms in the first week of life.

What are its symptoms?

The major symptom of this disorder is the stridor that is heard as the infant breathes. The stridor is usually heard when the infant breathes in (inspiration), but can also be heard when the infant breaths out (expiration). Other characteristics may include:

• Difficulty feeding
• The stridor worsens with activity and if the infant has an upper respiratory infection.

The symptoms of laryngomalacia may resemble other conditions or medical problems such as asthma. Always consult your child's physician for a diagnosis.

How is it diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures may include a bronchoscopy of the airways - a procedure which involves a tube being passed into the airways to allow your child's physician to observe the airways during breathing. Often flexible fiberoptic laryngoscopy done the the pediatric otolaryngologist's office can confirm the diagnosis in a few minutes.

Treatment for laryngomalacia

In most cases, the condition is harmless and resolves on its own without medical intervention. The condition usually improves by the time the infant is 18 months old but may last until age 2 or 3 years. It has no long-term complications. Each child's case is unique. About 10 percent develop respiratory problems which require medical or surgical interventions.

Laryngomalacia is usually accompanied by gastroesophageal reflux (spitting up). Your physician will probably recommend measures to prevent or minimize reflux.