Laryngomalacia is the most common cause of stridor (noisy breathing) in infants. It is a congenital (present at birth) anomaly of the larynx (voice box). It is due to an inward collapse of the floppy, soft upper structures of the larynx. It may progress for the first six months of life then gradually improve.
The major symptom is the stridor that is heard as the infant breathes. The stridor is usually heard when the infant breathes in (inspiration). Other characteristics may include:
- Difficulty feeding
- The stridor worsens with activity, feeding and with an upper respiratory infection
- Reflux (spitting up)
Symptoms of laryngomalacia may resemble other conditions or medical problems such as asthma. Always consult your child's physician for diagnosis and treatment. The stridor itself is not problematic. Difficulty breathing (the increased work of breathing) is the main concern.
The ear, nose and throat physician can see the problem with a tiny scope and camera. Flexible fiberoptic laryngoscopy is done in the pediatric otolaryngologist's office and can confirm the diagnosis in a few minutes. Subsequent diagnostic procedures may include bronchoscopy of the airways. This procedure involves passing a tube with a camera through the mouth to examine the airways while the child is under anesthesia. Airway and chest Xrays may be ordered.
In most cases, the condition is harmless and improves on its own without medical intervention. The condition usually resolves by the time the infant is 18 months old but stridor may last until age 2 or 3 years. There are no long-term complications. Few children require medical or surgical interventions.
Laryngomalacia is usually accompanied by gastroesophageal reflux. Your physician will probably recommend measures to prevent or minimize reflux.