Supraglottoplasty for Laryngomalacia
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2025-04-18
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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery
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University of Cape Town
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Abstract
Laryngomalacia is characterised by collapse of the supraglottic tissues on inspiration. It is the most common cause of stridor in infancy. It generally becomes symptomatic 2-3 weeks after birth, and presents as characteristic high-pitched, inspiratory, squeaking stridor. Classically symptoms are worse in the supine position, when the child cries, or is agitated. Males are affected twice as often as females. It usually resolves by the age of 2 years. Laryngomalacia may remain symptomatic beyond 2 years in patients with neuromascular disorders and should be considered in the differential diagnosis of inspiratory stridor even in older children. The aetiology is not fully understood. There does appear to be a familial predisposition. Anatomically, redundant supraglottic soft tissues collapse on inspiration and cause supraglottic airway obstruction. Another theory is that of immature neuromuscular development causing supraglottic compromise. A common coexisting condition is that of acid reflux which may exacerbate laryngomalacia by causing posterior supraglottic oedema.
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Reference:
Jonas, N. & van der Meer, G. 2025. Supraglottoplasty for Laryngomalacia. In Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery. J. Fagan, Ed.Cape Town, South Africa: University of Cape Town. 7. http://hdl.handle.net/11427/43520 .