Laryngomalacia is a congenital weakness of the laryngeal skeleton, especially the epiglottis and aryepiglottic fold.
Core of illness is an insufficient firmness (rigidity) of the cartilage that is located at the entrance to the larynx and weakness (hypotony) of neuromusculature in regions of gloss-pharyngolarynx. With this malformation there is a changed position and size of the epiglottis (the larynx lid).
Laryngomalacia is usually an isolated disease. But it may be associated with other malformations: micrognathia, macroglossia, glossoptosis and a cleft palate. Associated anomalies and functional disorders in patients with laryngomalacia are rare, but they can delay the healing process in a great deal.
Laryngomalacia in Infants
Laryngomalacia in infants immediately after birth is manifested as an inspirational laryngeal sridor of varying intensity. Stridor (hissing, wheezing) is constant regardless of the position of the child. It intensifies when the baby is crying, and reduces in while the baby is resting and sleeping and the voice remains unchanged. Laryngomalacia is sometimes accompanied by dyspnea (labored breathing), it is rarely accompanied by cyanosis and respiratory insufficiency.
Laryngeal stridor that occurs when the baby is crying can be enhanced by feeding, excitement and lying on back or on chest, it is reduced during resting and sleeping. Breathing can be remedied by raising the mandible upward.
Laryngomalacia Treatment consists of proper nutrition and infant care. It is necessary to provide enough vitamin C, D and calcium. In severe forms of laryngomalacia tracheotomy is done, but these are rare cases. Larynx development disorders usually disappear after the child reaches the age of two.
In a case of severe obstructive sleep apnea in children with laryngomalacia the surgical treatment is indicated. The possible occurrence of vocal cord paralysis can significantly complicate the clinical course by intensification of supraglottic obstruction symptoms and it can not be removed by a surgical intervention. Noninvasive mechanical ventilation is an alternative to surgical healing, providing effective ventilation and normal growth and development.
Laryngomalacia is most common of all malformations of the larynx.