Congenital laryngomalacia: Disease spectrum and management

Laryngomalacia is the most common laryngeal anomaly, affecting 45-75 % of infants with congenital stridor. Laryngomalacia is due to the dynamic prolapse of supraglottic tissues into the airway during inspiration. Prolapse of supraglottic tissues produces a variable amount of airway obstruction and inspiratory stridor. A majority of infants have mild disease and are managed expectantly. Those with moderate and severe disease are managed with gastroesophageal reflux therapy, feeding modifications, and surgical intervention. Surgical intervention is required in 20 % of infants. Supraglottoplasty is the mainstay of surgical treatment; tracheostomy is rarely needed.