Laryngomalacia

• What is laryngomalacia?

  Congenital anomaly of the larynx

  Characterised by an inward collapse of the supraglottic structures during inspiration
• When does laryngomalacia typically manifest?

  Within the first 2 weeks of life
• When does laryngomalacia typically resolve and why?

  18 - 24 months as the laryngeal cartilage matures
• WHat sex is laryngomalacia more ccommon in?

  Males
• What does laryngomalacia present clinically with?

  Stridor
• What is the most common cause of stridor in neonates?

  Laryngomalacia
• What are 3 risk factors for laryngomalacia?

  Male

  Premature birth

  Firstborn status
• What is laryngomalacia marked by?

  Malformation of the laryngeal cartilage = inward collapse of supraglottic structures
• How many different types of laryngomalacia are there?

  3
• What shape does the laryngeal inlet make in type 1 laryngomalacia?

  Omega shaped
• What is another name for type 1 laryngomalacia?

  Curling type
• What is another name for type 2 laryngomalacia?

  Prolapsing type
• Which type of laryngomalacia has the more severe symptoms?

  Type 3
• What is another name fro type 3 laryngomalacia?

  Posterior displacement type
• What may more severe forms of laryngomalacia need?

  Interventions like supraglottoplasty
• What are some clinical features of laryngomalacia?

  Inspiratory stridor

  Feeding difficulties

  Failure to thrive

  Cyanosis

  Resp distress
• What are some investigations for laryngomalcia?

  Oxygen sats should be monitored

  ABGs

  Laryngoscopy and bronchoscopy (if there is diagnostic difficulty)
• What are some differentials for laryngomalacia?

  Vocal cord paralysis

  Subglottic stenosis

  Tracheomalacia
• How is laryngomalacia managed?

  Normally resolves spontaneously by 18 - 24 months
• When is surgical intervention required in laryngomalacia?

  Severe resp distress
• What are some complications of laryngomalacia?

  Failure to thrive

  Resp distress

  GORD

  Sleep apnoea

  Pneumonia

  Pulmonary hypertension
• Why can failure to thrive occur in laryngomalacia?

  Increased work of breathing and feeding difficulties = growth retardation and inability to gain weight