Complications include problems with acute airway obstruction and perioperative morbidity and mortality. Laryngomalacia Laryngomalacia is a collapse of the supraglottic laryngeal structures. This produces symptoms on inspiration since these floppy structures, such as the epiglottis and aryepiglottic folds, may be pulled into the airway during inspiration. The presumptive diagnosis is made based on history and physical examination, but further evaluation is needed. Definitive diagnosis is based on bronchoscopy findings showing the floppiness of the laryngeal structures during the respiratory cycle.
Treatment is usually conservative by changing feeding postures and feeding the infant slowly.
Laryngoplasty, either via laser surgery or traditional means, can also relieve symptoms in select cases. Rarely do children need tracheotomy. These children also have exacerbations with intercurrent respiratory illnesses and therefore need good parental monitoring. The long-term prognosis is good as these children outgrow their problem. Differential diagnosis includes malformation of the laryngeal cartilages or vocal cords including congenital vocal cord paralysis , laryngeal webs, mucus retention cysts, hemangioma, lymphangioma, goiters, thyroglossal duct remnants, branchial cleft cysts, tetany, and laryngeal edema secondary to trauma or aspiration at birth.