Laryngomalacia is a common condition of newborns and is the most common cause of stridor in infants.Laryngomalacia-associated stridor is often described as high pitched and frequently occurs during the inspiratory phase of respiration, during which the lack of neuromuscular or structural support allows the upper portions of the larynx (voice-box) structures to prolapse (be sucked in). The majority cases of laryngomalacia are self-limited and resolve by the age of 12 to 24 months, but an estimated 10% to 30% are severe enough to require surgical intervention. Disease severity is generally classified as mild, moderate, or severe based on associated feeding and obstructive symptoms.
Mild disease is described as inconsequential intermittent stridor and sporadic feeding difficulties, and moderate disease presents with difficulty breathing and feeding difficulties.Severe laryngomalacia is present in approximately 20% of infants with stridor and is characterized by recurrent cyanosis (turning blue) or apneic events (pauses in breathing) often with difficulty feeding and problems gaining weight.
It is estimated that 65% to 100% of infants with laryngomalacia also suffer from gastroesophageal reflux disease (GERD).This association with GERD often results in acid spillage onto the larynx (voice-box) and worsening of disease through associated swelling and desensitization.Currently, it is recommended that most or all laryngomalacia patients with feeding difficulties be treated for GERD with acid suppression therapy (medication and feeding adjustments).