Laryngomalacia : diagnosis and management

Abstract EN

Background: Laryngomalacia is the term most widely used to describe the ‘‘inward collapse of supraglottic structures of the larynx during inspiration’’.

It is considered to be the most common cause of congenital stridor.

Laryngomalacia usually presents by high pitched inspiratory stridor which is often present at birth and is usually noticed by 2 weeks of age.

Stridor in laryngomalacia is usually positionally dependent and is worse at times of increased work of breathing.

Diagnosis depends mainly on visualization of the larynx during respiration.

Spontaneous resolution of symptoms is the rule, it usually occurs by the age of 2–5 years.

Surgical intervention is indicated only in severe cases of laryngomalacia.

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.

Methods: The medical sheath records of newborns and infants suffering of laryngomalacia were reviewed regarding demographic data, clinical presentation, diagnosis and management.

Results: Fifty eight infant and child were included in the study.

They were 33 males (57%) and 25 females (43%).

Their age at presentation ranged from 2 to 13 months with mean age of 6.3 months.

Diagnosis was done using laryngoscopy under general anesthesia with spontaneous breathing in 49 patients (85%) and by using flexible nasopharyngolaryngoscopy under topical anesthesia in 9 patients (15%).

Conservative treatment was given for all cases in the form of diet modification, These procedures try to eliminate inspiratory obstruction by widening the supraglottis and have demonstrated to be efficacious in correcting all anatomic anomalies associated with laryngomalacia.18