Laryngomalacia (LM) is the most common cause of stridor in children. It
presents during the first days of life with inspiratory stridor often associated with
feeding difficulties. Diagnosis must be confirmed by performing a flexible fiberoptic
laryngoscopy. LM is classified in mild, moderate and severe LM depending on
respiratory and feeding severity symptoms. LM usually goes with gastroesophageal
reflux disease, and can also be associated to synchronous airway lesions, neurological
disorders, heart disease and congenital syndromes. Identification and management of
co-morbidities using appropriate complementary examinations are essential as they
influence LM severity and treatment outcomes. Medical management of LM includes
lifestyle/dietary measures and anti-acid treatment. Supraglottoplasty, including several
technique variants, is the mainstay of severe LM treatment, with numerous studies
reporting high success and low complications rates. Tracheotomy and non-invasive
ventilation are indicated in case of supraglottoplasty failure, most of the time due to
associated neurological disorder and congenital syndromes.
Keywords: Gastroesophageal reflux disease, Inspiratory supraglottic collapse,
Laryngomalacia, Lifestyle/dietary measures, Neonates and infants, Non-invasive
ventilation, Stridor, Tracheotomy, Trans-oral supraglottoplasty.
