Laryngomalacia: Difference between revisions

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__NOTOC__
__NOTOC__
'''For patient information, click [[Laryngomalacia (patient information)|here]]'''
{{Infobox_Disease
{{Infobox_Disease
  | Name          = {{PAGENAME}}
  | Name          = {{PAGENAME}}
  | Image          = Laryngomalacia.jpg
  | Image          = Laryngomalacia.jpg
  | Caption        = Omega shaped epiglottis, seen in laryngomalacia
  | Caption        = Omega shaped epiglottis, seen in laryngomalacia
| DiseasesDB    = 29421
| ICD10          = {{ICD10|Q|31|5|q|30}}
| ICD9          = {{ICD9|748.3}}
| ICDO          =
| OMIM          = 150280
| MedlinePlus    =
| eMedicineSubj  = ped
| eMedicineTopic = 1280
| MeshID        =
}}
}}
{{SI}}
{{Laryngomalacia}}
{{CMG}}
{{CMG}}


{{SK}} Laryngotracheomalacia; tracheolaryngomalacia; soft larynx.
{{SK}} Laryngotracheomalacia; tracheolaryngomalacia; soft larynx.
==Overview==
==[[Laryngomalacia overview|Overview]]==
 
==[[Laryngomalacia historical perspective|Historical Perspective]]==
Laryngomalacia is the commonest cause of [[stridor]] in infancy, in which the soft, immature [[cartilage]] of the upper larynx collapses inward during inhalation, causing airway obstruction.  It can also be seen in older patients, especially those with neuromuscular conditions resulting in weakness of the muscles of the throat.  However, the infantile form is much more common.
==[[Laryngomalacia classification|Classification]]==
 
==[[Laryngomalacia pathophysiology|Pathophysiology]]==
==Presentation==
==[[Laryngomalacia causes|Causes]]==
In infantile laryngomalacia, the supraglottic [[larynx]] (the part above the [[vocal cords]]) is tightly curled, with a short band holding the cartilage shield in the front (the [[epiglottis]]) tightly to the mobile cartilage in the back of the larynx (the arytenoids).  These bands are known as the aryepiglottic folds; they create the movements that opens and closes the vocal cords for phonation.  The shortened aryepiglottic folds cause the epiglottis to be curled on itself.  This is the well known "[[omega]] shaped" epiglottis in laryngomalacia.
==[[Laryngomalacia differential diagnosis|Differentiating Laryngomalacia from other Diseases]]==
 
==[[Laryngomalacia epidemiology and demographics|Epidemiology and Demographics]]==
Laryngomalacia results in partial airway obstruction, most commonly causing a characteristic high-pitched squeaking noise on inhalation (inspiratory [[stridor]]).  Some infants have feeding difficulties related to this problem.  Rarely, children will have significant life threatening airway obstruction.  The vast majority, however, will only have stridor without other more serious symptoms such as dyspnea (difficulty breathing).
==[[Laryngomalacia risk factors|Risk Factors]]==
 
==[[Laryngomalacia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==Causes==
Although laryngomalacia is not associated with a specific gene, there is evidence that some cases may be inherited.<ref>{{cite journal |author=Shulman JB, Hollister DW, Thibeault DW, Krugman ME |title=Familial laryngomalacia: a case report |journal=Laryngoscope |volume=86 |issue=1 |pages=84–91 |year=1976 |pmid=1256207 |doi=10.1288/00005537-197601000-00018}}</ref><ref>{{cite journal |author=Shohat M, Sivan Y, Taub E, Davidson S |title=Autosomal dominant congenital laryngomalacia |journal=Am. J. Med. Genet. |volume=42 |issue=6 |pages=813–4 |year=1992 |pmid=1554019 |doi=10.1002/ajmg.1320420613}}</ref>  Relaxation or a lack of muscle tone in the upper airway may be a factor. It is often worse when the infant is on his or her back, because the floppy tissues can fall over the airway opening more easily in this position.<ref name=chop>{{cite web |url=http://www.chop.edu/service/airway-disorders/conditions-we-treat/laryngomalacia.html |title="Laryngomalacia | The Children's Hospital of Philadelphia" |author= |date= |work= |publisher=The Children's hospital of Philadelphia |accessdate=31 August 2012}}</ref>
 
==Diagnosis==
==Diagnosis==
The physician will ask some questions about the baby’s health problems and may recommend a flexible [[laryngoscopy]] to further evaluate the infant's condition.<ref name=chop />
==Prognosis==
Laryngomalacia becomes symptomatic after the first few weeks of life, and may get louder over the first year, as the child moves air more vigorously.


[[Laryngomalacia history and symptoms|History and Symptoms]] | [[Laryngomalacia physical examination|Physical Examination]] | [[Laryngomalacia laboratory findings|Laboratory Findings]] | [[Laryngomalacia x ray|X Ray]] | [[Laryngomalacia CT|CT]] | [[Laryngomalacia MRI|MRI]] | [[Laryngomalacia endoscopy|Endoscopy]] | [[Laryngomalacia other imaging findings|Other Imaging Findings]] | [[Laryngomalacia other diagnostic studies|Other Diagnostic Studies]]
==Treatment==
==Treatment==
Time is the only treatment necessary in more than 90% of infant cases.<ref>{{cite web |author=Bye Michael R MD |title="Laryngomalacia: Treatment & Medication"|publisher=eMedicine from WebMD |url=http://emedicine.medscape.com/article/1002527-treatment |date=September 13, 2007 }}</ref> In other cases, surgery may be necessary.<ref>{{cite journal |author=Holinger LD, Konior RJ |title=Surgical management of severe laryngomalacia |journal=Laryngoscope |volume=99 |issue=2 |pages=136–42 |year=1989 |pmid=2913424 |doi=10.1288/00005537-198902000-00004}}</ref><ref>{{cite journal |author=Zalzal GH |title=Stridor and airway compromise |journal=Pediatr. Clin. North Am. |volume=36 |issue=6 |pages=1389–402 |year=1989 |pmid=2685719 |doi=}}</ref><ref>{{cite journal |author=Solomons NB, Prescott CA |title=Laryngomalacia. A review and the surgical management for severe cases |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=13 |issue=1 |pages=31–9 |year=1987 |pmid=3305399 |doi=10.1016/0165-5876(87)90005-X}}</ref> Most commonly, this involves cutting the aryepiglottic folds to let the supraglottic airway spring open.  Treatment of [[gastroesophageal reflux]] disease can also help in the treatment of laryngomalacia, since gastric contents can cause the back part of the larynx to swell and collapse even further into the airway.  In some cases, a temporary [[tracheostomy]] may be necessary.
[[Laryngomalacia medical therapy|Medical Therapy]] | [[Laryngomalacia surgery|Surgery]] | [[Laryngomalacia primary prevention|Primary Prevention]] | [[Laryngomalacia secondary prevention|Secondary Prevention]] | [[Laryngomalacia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Laryngomalacia future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
==References==
[[Laryngomalacia case study one|Case #1]]
{{reflist}}
{{clr}}
 
[[Category:Congenital disorders of respiratory system]]
 
 
{{disease-stub}}
{{Congenital malformations and deformations of respiratory system}}


[[Category:Disease]]
[[Category:Emergency medicine]]
[[ar:لين الحنجرة]]
[[ar:لين الحنجرة]]
[[de:Laryngomalazie]]
[[de:Laryngomalazie]]

Latest revision as of 19:06, 6 February 2013

For patient information, click here

Laryngomalacia
Omega shaped epiglottis, seen in laryngomalacia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Laryngotracheomalacia; tracheolaryngomalacia; soft larynx.

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Laryngomalacia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Endoscopy | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

ar:لين الحنجرة de:Laryngomalazie it:Laringomalacia fi:Laryngomalasia

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