THROAT - Laryngomalacia

What is laryngomalacia?

It is an excessive flaccidity of the supraglottic portion of the larynx and is one of the cause of congenital stridor.

What is the Aetiology of laryngomalacia?

1.       Age :Occurs in infants
2.       More common in lower socioeconomic patients
3.       Poor nutrition
4.       Occurs due to large omega shaped epiglottis, bulky aryepiglottic
folds and excessive tissue flaccidity

What are the clinical features of laryngomalacia?

1.       Inspiratory stridor present at birth or even several weeks after birth
2.       Suprasternal indrawing may be present
3.       Stridor is worse when the child is supine and better when prone
4.       Rarely cyanosis and dyspnoea
5.       Stridor often interferes with feeding
6.       Respiratory infection precipitates the stridor needing urgently treatment

Diagnosis: Direct laryngoscopy is done, with the blade of the laryngoscope in the vallecula of the larynx.

The stridor is relieved by inserting the blade of the laryngoscope into the vestibule of the larynx.

The vestibule and aryepiglottic fold invaginates in the larynx.
After diagnosis of  Laryngomalacia , tracheomalacia and
bronchomalacia must be ruled out.

What is the treatment of laryngomalacia?

1. No active treatment necessary
2. Rarely tracheostomy may be required
3. Reassurance to parents
4. Vitamin D supplementation
5. Treatment of the upper respiratory tract infection if any.




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