Laryngomalacia is a congenital condition where the soft tissue above the vocal cords is floppy and collapses into the airway during breathing, causing noisy breathing (stridor). It primarily affects infants and can lead to feeding difficulties and breathing issues. In most cases, it resolves on its own, but severe cases may require medical intervention, including surgery or speech therapy to address related feeding or airway concerns.
Contents
Overview
What is Laryngomalacia?
Laryngomalacia is a condition present at birth where the soft, immature tissue of the larynx (voice box) falls into the airway when the infant breathes, causing a characteristic high-pitched, squeaky noise known as stridor. It is the most common cause of noisy breathing in infants and is usually benign, resolving as the infant grows and the airway matures. In more severe cases, laryngomalacia may cause feeding difficulties, poor weight gain, or breathing problems that require medical attention.
Symptoms and Causes
What are the first signs of Laryngomalacia?
The primary symptom of laryngomalacia is noisy breathing (stridor), particularly when the infant is feeding, crying, or lying on their back. Other symptoms may include:
- Difficulty feeding
- Poor weight gain
- Recurrent choking or gagging
- Apnea (pauses in breathing)
- Reflux symptoms, such as frequent spitting up
What causes Laryngomalacia?
Laryngomalacia is caused by the abnormal development of the larynx, resulting in floppy tissue above the vocal cords that collapses into the airway during inhalation. The exact cause of the abnormality is unknown, but it is believed to be related to immature development of the structures that support the airway. Most cases are sporadic and not inherited.
Diagnosis and Tests
How is Laryngomalacia diagnosed?
Laryngomalacia is typically diagnosed based on a physical exam and medical history. To confirm the diagnosis, the following tests may be performed:
- Flexible Laryngoscopy: A small camera is inserted through the nose to visualize the larynx and airway structures.
- Bronchoscopy: This procedure may be done in more severe cases to examine the airway and lungs in detail.
- Sleep Study: In infants with breathing difficulties, a sleep study may be used to monitor oxygen levels and breathing patterns.
Management and Treatment
How is Laryngomalacia treated?
Most cases of laryngomalacia do not require treatment and resolve on their own as the child grows. However, in more severe cases, treatment options include:
- Watchful Waiting: Monitoring the infant’s growth and symptoms, as many cases improve as the airway matures.
- Speech and Feeding Therapy: In cases where feeding difficulties occur, speech therapy can help improve feeding skills and reduce the risk of aspiration.
- Surgery: In rare cases of severe laryngomalacia, a surgical procedure called supraglottoplasty may be performed to remove the excess tissue and improve airflow.
- Reflux Management: Since many infants with laryngomalacia also have reflux, medications to control acid reflux may be prescribed.
Prevention
Can Laryngomalacia be prevented?
Laryngomalacia is a congenital condition, meaning it is present at birth and cannot be prevented. However, early diagnosis and monitoring can help manage symptoms and ensure proper growth and development.
Outlook / Prognosis
What is the outlook for people with Laryngomalacia?
The prognosis for most infants with laryngomalacia is excellent, with the condition typically resolving on its own by the age of 18-24 months. In cases of severe laryngomalacia requiring surgery, the outlook is also good, with most children experiencing significant improvement in breathing and feeding. Long-term complications are rare.
Living With Laryngomalacia
How can you manage Laryngomalacia?
For most infants, managing laryngomalacia involves regular monitoring of breathing and feeding. Parents should watch for signs of breathing difficulty, poor feeding, or inadequate weight gain, and report these concerns to their healthcare provider. In cases of severe symptoms, speech or feeding therapy may be recommended to support proper nutrition and growth.
When should I see a speech therapist for Laryngomalacia?
If your infant is having difficulty feeding, gaining weight, or choking frequently, a speech therapist with expertise in feeding disorders can provide interventions to improve feeding skills and reduce the risk of aspiration.
FAQ
- How does Laryngomalacia affect speech and communication?
Laryngomalacia primarily affects breathing and feeding in infancy and does not usually impact speech development directly. However, severe cases that require surgical intervention may benefit from speech therapy to support overall airway health.
- What kind of therapy is most effective for Laryngomalacia?
Feeding therapy, provided by a speech therapist, is often effective for infants with laryngomalacia who have difficulty feeding. In severe cases, surgery may be necessary to correct the airway obstruction.
- Can Laryngomalacia improve with speech therapy?
Speech therapy can help infants with feeding difficulties related to laryngomalacia improve their ability to feed safely and efficiently. It is especially beneficial for preventing aspiration and supporting healthy growth.
- Are there long-term effects of Laryngomalacia on speech and communication?
Most children with laryngomalacia outgrow the condition without long-term effects on speech or communication. However, in severe cases, ongoing monitoring of speech and airway function is recommended.