larynx (infantile)

Last reviewed 01/2018

Laryngomalacia is a congenital laryngeal stridor characterised by flaccidity of supraglottic structures. It accounts for 60-70% of cases of congenital stridor, and affects both sexes equally.

Presentation occurs soon after birth or may not be obvious until the child becomes active or develops an acute upper respiratory tract infection. The stridor occurs on inspiration only, and is high-pitched and crowing. It may be intermittent appearing only when the child is feeding or crying. It is more pronounced during sleep especially if the child lies on its back. Symptomatic relief may be provided by hyperextending the neck.

Typically, symptoms increase in severity during the first 8 months, reach a maximum at 9-12 months, and then resolve.

Very rarely, the condition may cause sufficient respiratory distress that active treatment is indicated. Options include tracheostomy, excision of redundant mucosa, or laser division of the aryepiglottic folds.