Laryngomalacia: Symptoms, Causes, Treatment

What are the symptoms of laryngomalacia?

Laryngomalacia is a condition in which the soft tissues of the larynx (voice box) are floppy and collapse inward, obstructing the airway. The symptoms of laryngomalacia can vary in severity and may include:

1. Stridor: A high-pitched, harsh sound caused by the obstruction of the airway.
2. Coughing: Coughing fits that may be triggered by feeding or lying down.
3. Choking: Feeling like food or liquids are getting stuck in the throat.
4. Breathlessness: Difficulty breathing or feeling like there is not enough air getting in.
5. Fussiness: Irritability and fussiness due to discomfort or difficulty breathing.
6. Apnea: Periods of apnea (breathing cessation) can occur, especially during sleep.
7. Recurrent respiratory infections: Recurring respiratory infections, such as bronchitis or pneumonia, may occur due to chronic aspiration of food and liquids into the lungs.
8. Failure to thrive: In severe cases, laryngomalacia can lead to failure to thrive due to chronic respiratory distress and malnutrition.

In some cases, laryngomalacia may not cause any noticeable symptoms until the infant is several months old. In other cases, it may be diagnosed during prenatal ultrasound or immediately after birth.

It’s essential to consult with a pediatrician or ear, nose, and throat (ENT) specialist for proper evaluation and diagnosis of laryngomalacia.

What are the causes of laryngomalacia?

Laryngomalacia is a congenital condition, meaning it is present at birth, and it is caused by a combination of genetic and environmental factors. The exact causes of laryngomalacia are not fully understood, but it is thought to be related to the following:

1. Weakened laryngeal cartilage: The cartilage in the larynx (voice box) may be weak or underdeveloped, leading to collapse of the soft tissues.
2. Abnormal laryngeal development: Abnormal development of the larynx during fetal development may lead to laryngomalacia.
3. Genetic predisposition: Some cases of laryngomalacia may be inherited, and certain genetic mutations may contribute to the development of the condition.
4. Environmental factors: Exposure to environmental toxins or chemicals during fetal development may also contribute to the development of laryngomalacia.
5. Maternal smoking: Maternal smoking during pregnancy has been linked to an increased risk of laryngomalacia in children.
6. Prematurity: Premature birth has also been linked to an increased risk of laryngomalacia.
7. Other conditions: Certain conditions such as trisomy 13, diaphragmatic hernia, and other congenital anomalies may increase the risk of developing laryngomalacia.

It’s essential to consult with a pediatrician or ear, nose, and throat (ENT) specialist for proper evaluation and diagnosis of laryngomalacia.

How is the diagnosis of laryngomalacia made?

The diagnosis of laryngomalacia is typically made through a combination of clinical evaluation, physical examination, and diagnostic tests. Here are the steps involved in diagnosing laryngomalacia:

1. Clinical evaluation: A pediatrician or ear, nose, and throat (ENT) specialist will perform a thorough clinical evaluation of the child’s symptoms, medical history, and physical examination.
2. Physical examination: A physical examination will be performed to assess the child’s overall health, including their respiratory system, airway patency, and neck and throat anatomy.
3. Laryngeal exam: A laryngeal exam will be performed to examine the larynx (voice box) and surrounding tissues using a laryngoscope or flexible endoscope.
4. Endoscopy: Endoscopy may be performed to visualize the larynx and surrounding tissues in more detail.
5. Imaging studies: Imaging studies such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans may be ordered to rule out other conditions that may be causing similar symptoms.
6. Flexible bronchoscopy: Flexible bronchoscopy may be performed to examine the airway and surrounding tissues in more detail.
7. Laryngeal manometry: Laryngeal manometry may be performed to measure the pressure and flow of air through the airway.
8. Chest X-ray: A chest X-ray may be ordered to rule out other conditions that may be causing respiratory distress.

In some cases, laryngomalacia may be diagnosed prenatally through ultrasound examination during pregnancy.

It’s essential to consult with a pediatrician or ENT specialist for proper evaluation and diagnosis of laryngomalacia.

What is the treatment for laryngomalacia?

The treatment for laryngomalacia typically involves a combination of medical and surgical interventions. The goal of treatment is to manage symptoms, improve breathing, and prevent complications. Here are some common treatments for laryngomalacia:

Medical treatment:

1. Monitoring: Close monitoring of the child’s respiratory status and oxygen saturation is essential to prevent complications.
2. Oxygen therapy: Supplemental oxygen may be provided to help increase oxygen levels in the blood.
3. Positioning: Positioning the child in a way that opens up the airway can help improve breathing.
4. Vocal hygiene: Teaching parents proper vocal hygiene techniques can help reduce vocal cord irritation.
5. Speech therapy: Speech therapy may be recommended to help improve speech and communication skills.

Surgical treatment:

1. Laryngoscopy: A laryngoscopy may be performed to evaluate the extent of the laryngeal collapse and to remove any debris or mucus from the airway.
2. Tuboplasty: A tuboplasty is a surgical procedure that involves reconstructing the trachea and bronchi to improve airflow.
3. Tracheostomy: In some cases, a tracheostomy may be necessary to establish a direct airway.
4. Laryngeal elevation surgery: Laryngeal elevation surgery involves surgically elevating the larynx to improve airflow.

Other interventions:

1. CPAP therapy: Continuous positive airway pressure (CPAP) therapy may be used to help maintain a patent airway.
2. Bi-level positive airway pressure (BiPAP) therapy: BiPAP therapy is similar to CPAP therapy but provides different pressures for inspiration and expiration.

It’s essential to consult with a pediatrician or ear, nose, and throat (ENT) specialist for proper evaluation and treatment of laryngomalacia.