Laryngomalacia article

The term Malakia in Greek ¹ means softening. The term indicates softening of larynx.
This is a disease of infants and children. This disease is characterised by the presence of stridor (inspiratory) which is caused due to excessive redundancy of supraglottic tissues ² which gets sucked into the glottis due to the negative pressure caused during inspiration. The term laryngomalacia was first coined by Chevalier Jackson in 1942 ³. The stridor in these patients are inspiratory in nature. Laryngomalacia is the leading cause of stridor in infants accounting for approximately 70% ⁴.

Age of onset:
This condition gets manifested within first two weeks after birth and usually resolves when the child reaches the age of 2.

Pathophysiology ⁵:

1. Excessive redundancy of supraglottic soft tissues
2. Immaturity of neuromuscular system
3. Immaturity of cartilages of larynx
4. GERD
5. Submucosal gland hyperplasia

Possible mechanisms causing stridor in these patients include:

1. Indrawing of cuneiform cartilages on inspiration
2. Omega shaped epiglottis of infants curls upon itself
3. The arytenoids collapse inwards
4. The epiglottis gets displaced against the posterior pharyngeal wall
5. Short aryepiglottic folds
6. Overtly acute angle of epiglottis at the laryngeal inlet

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