Laryngomalacia

Laryngomalacia

Some parents will notice that the breathing of their child while sleeping is abnormally loud. It differs from snoring, and is often the result of a birth defect, but with proper care from ENT for Children, it can be treated.

What is laryngomalacia?

Laryngomalacia is a condition which affects the larynx (voice box) of a child. It is comprised of floppy tissue which can be found on top of the vocal cords. When the child breathes this floppy tissue will slip down inside the airway. The exact cause of this condition is not known to doctors, but it is partly a result of the underdeveloped region of the nervous system which provides tone for the airway.

Laryngomalacia ranges from mild to severe. Most children will only have a mild case of this condition, and will display noisy breathing that may annoy caretakers, but won’t cause any serious health problems. Severe cases of laryngomalacia are rare, but when present the child will have a number of problems in addition to noisy breathing, some of which can be serious (such as choking or regurgitating food).

What are the symptoms of laryngomalacia?

The symptoms most commonly associated with laryngomalacia include an intermittent breathing sound whenever a baby breathes in or out. The breathing may be reduced or exasperated depending on the position in which the child is lying. The inspiratory stridor will become worse whenever the baby is excited, agitated or crying. These symptoms begin from the time the child is born, and will increase after a period of about ten days. The majority of children who have this condition will outgrow it in 12 to 18 months. Additional symptoms consist of:

  • Difficulty feeding the child
  • Low weight gain
  • Chokes on food
  • Vomiting out food
  • Retraction of the chest or neck
  • Pauses when breathing
  • Spitting out stomach acid

How is the diagnosis established?

There are a number of tests which Dr. Samadi can use to diagnose this condition within children, and one of these is flexible laryngoscopy. With this procedure a laryngoscope will be sent through the mouth and nose, and he will examine the tissue on top of the vocal cords to see if they have a floppy shape. He will also check the child’s upper airway to determine if there are additional problems which may cause the noisy breathing. Dr. Samadi may also recommend X-rays of the chest or neck as these can detect problems within the trachea or lungs.

How is laryngomalacia treated?

Laryngomalacia treatment will often occur on its own, and babies will grow out of it within two years. In rare cases where the condition persists, a surgical operation called a supraglottoplasty will be needed. With this procedure, Dr. Samadi will slice the floppy tissue above the vocal cords while the child is under anesthesia.

This operation will be performed through the child’s mouth. A breathing tube will be provided to the child after the operation is complete, and they will be required to stay in the hospital overnight where they will be monitored by the Pediatric Intensive Care Unit. This surgery has been found to either eliminate or drastically reduce laryngomalacia, and parents with questions about this procedure should contact us.