Classic laryngomalacia presents in the awake infant with progressive stridor when agitated. Occult laryngomalacia usually presents with stridor in children older than 2 years and is limited to sleep or exercise. [ncbi.nlm.nih.gov]

• Hypoxemia

  Recent data suggest infants with laryngomalacia and hypoxemia may more readily develop pulmonary hypertension. [8] Therefore, children with hypoxemia should periodically undergo evaluation for pulmonary hypertension. [emedicine.medscape.com]

  If the baby has clinically significant hypoxemia, supplementary oxygen should be administered. [njssjournal.org]

  Mortality/Morbidity Rarely, the lesion may cause enough hypoxemia or hypoventilation to interfere with normal growth and development. [emedicine.com]

  Only a small number of children with severe symptomatic disease, e.g., hypoxemia, apnea, or failure to thrive, require surgical treatment. 2 Definitive diagnosis of laryngomalacia can be confirmed with flexible fiberoptic laryngoscopy. [anesthesiology.pubs.asahq.org]

• Pathologist

  Evaluation of swallowing was performed at two time points by two blinded speech-language pathologists, one responsible for clinical evaluation and the other for videofluoroscopic study. [ncbi.nlm.nih.gov]

• Multiple Congenital Anomalies

  This combination of multiple congenital anomalies has not been described previously and may represent a previously undescribed syndrome with autosomal inheritance. [ncbi.nlm.nih.gov]

• Nasal Flaring

  Physical Exam: The first step in evaluation of any patient with stridor is to assess for signs of respiratory collapse: Cyanosis Intercostal, subxyphoid, and supraclavicular contractions Nasal flaring Marked agitation Assess the timing of stridor with [medicine.uiowa.edu]

  The severity of these signs and symptoms is an indication of the severity of the obstruction: Retractions Nasal flaring Poor feeding Inadequate weight gain or failure to thrive Increased spitting up, gastroesophageal reflux (GER), or overt gastroesophageal [cancertherapyadvisor.com]

• Tachypnea

  Referral to a specialist such as the Children’s ENT and Facial Plastic Clinic is appropriate if one or more of the following criteria are met in addition to noisy breathing/stridor: Respiratory distress- tachypnea, retractions, tracheal tugging, apnea [childrensmn.org]

• Rhinitis

  In this report, we describe two patients with acquired idiopathic laryngomalacia with reference to allergic rhinitis and high serum levels of immunoglobulin E. [ncbi.nlm.nih.gov]

• Macroglossia

  […] causing tongue base collapse Macroglossia (primary) Hypopharyngeal obstruction: Vallecular cyst Laryngomalacia Glottic obstruction: Unilateral or bilateral vocal fold paralysis Laryngeal web or cleft Postintubation edema and/or granulation Laryngeal [cancertherapyadvisor.com]

• Thrombosis

  A case of an 11-year-old boy who presented with basilar artery thrombosis and a midpontine infarction is described. [ncbi.nlm.nih.gov]

• Suggestibility

  CONCLUSION: Every review article or survey of opinion suggests that there is still a marked variation in individual practice and a lack of consensus. [ncbi.nlm.nih.gov]

If the baby has normal cry, normal weight gain, normal development, and purely inspiratory noise that developed within the first 2 months of life, then no further workup may be necessary. [emedicine.medscape.com]

CONCLUSIONS: AF is a commonly used modality in the diagnostic workup of a patient with stridor. The effectiveness of AF is limited when compared to endoscopy when used for the evaluation of laryngomalacia. [ncbi.nlm.nih.gov]

The workup will begin with a thorough medical history. To follow, a flexible fiberoptic laryngoscopy will be performed safely at your otolaryngologist’s (ENT’s) office. [texaschildrens.org]

Currently, supraglottoplasty is considered the standard treatment of severe laryngomalacia. OBJECTIVE: To describe the experience of the authors in the surgical treatment of patients with severe laryngomalacia. METHODOLOGY: A retrospective study. [ncbi.nlm.nih.gov]

Supraglottoplasty can be performed bilaterally (on both the left and right sides at the same time), or be staged where only one side is operated on at a time. [9] Treatment of gastroesophageal reflux disease can also help in the treatment of laryngomalacia [en.wikipedia.org]

Chapman & Hall Medical 1995): Prognosis: Good in cases treatable by simple aortopexy. [kidsdoc.at]

Despite the primarily benign nature of laryngomalacia, comorbid conditions can exacerbate symptoms and negatively affect the prognosis. Aryepiglottoplasty can be performed with high success and low complication rates in properly selected patients. [ncbi.nlm.nih.gov]

Aim: The aim of this study was to assess clinical presentation, management and prognosis of infants and children suffering from laryngomalacia presented to our department in the period of 5 years. [nature.com]

Conclusion: In most children, the prognosis is favorable, as airway obstruction is not severe, and the symptoms improve in patients younger than 2 years. [thieme-connect.com]

Treatment and prognosis Treatment is largely supportive since most children show spontaneous resolution after 12-24 months. When associated gastro-esophageal reflux disease is present, that should be treated. [radiopaedia.org]

Abstract Laryngomalacia is an entity of ill-defined etiology. The clinical situation is one of inspiratory stridor present at birth, or within the newborn period. [ncbi.nlm.nih.gov]

This report suggests that etiologic and pathophysiologic heterogeniety exists for the clinical syndrome of laryngomalacia. [doi.org]

Some authors suggest that mucosal inflammation as the result of gastro-esophageal reflux disease (GERD) may also be an etiological consideration 2. Where there is suspicion of GERD, it should be treated. [radiopaedia.org]

Thus, the presence of these events of central apnea could reinforce the hypothesis of neuromuscular immaturity as an etiology of laryngomalacia. [scielo.br]

Epidemiological data along with symptoms, comorbidities, morphological type of laryngomalacia, synchronous airway lesions, surgery outcomes and satisfaction of parents after the procedure were recorded. [ncbi.nlm.nih.gov]

Epidemiology [ edit ] Although this is a congenital lesion, airway sounds typically begin at age 4–6 weeks. Until that age, inspiratory flow rates may not be high enough to generate the sounds. [en.wikipedia.org]

[…] neuromuscular control of the supportive cartilaginous structures of the airway Supraglottic edema due to laryngeal inflammation Most cases of laryngomalacia resolve by 18-24 months, however, 10% will present with severe features requiring surgical intervention Epidemiology [medicine.uiowa.edu]

Epidemiology Frequency United States Frequency is unknown. Often, the diagnosis is presumed. Mortality/Morbidity Rarely, the lesion may cause enough hypoxemia or hypoventilation to interfere with normal growth and development. [emedicine.com]

Despite its being widely discussed in the literature, the pathophysiology is not clearly understood. Both anatomic and neuromuscular theories have been suggested to explain laryngomalacia. [ncbi.nlm.nih.gov]

Tracheomalacia Pathophysiology – expiratory collapse of the intrathoracic airway, due to defective cartilaginous support. [pedclerk.bsd.uchicago.edu]

Vicencio, MD Sanjay Parikh, MD Albert Einstein College of Medicine and Children’s Hospital at Montefiore Bronx, NY Tracheomalacia and Bronchomalacia in Children: Pathophysiology, Assessment, Treatment and Anaesthesia Management. Austin J, Ali T. [pedsinreview.aappublications.org]

Prevention There are no current guidelines to prevent laryngomalacia because the cause is not known. [winchesterhospital.org]

While you can’t prevent laryngomalacia, you may be able to help prevent medical emergencies related to the condition. Consider the following strategies: Know what signs to look for when it comes to feeding, weight gain, and breathing. [healthline.com]

Premedication of patients with laryngomalacia is essential to prevent vagal responses and as an antisialogogue, sedation is to be used judiciously. [ijaweb.org]

Treatment may also be done to prevent future problems with the heart and lungs. What are the symptoms? The main symptom is a high-pitched, squeaking sound when your child inhales. [healthy.kaiserpermanente.org]