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Tracheomalacia/Laryngomalacia, Pediatric

Thomas G. Saba, MD and Amy G. Filbrun, MD, MS Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Malacia refers to “softness” of airway structures.

  • Laryngomalacia

    • Dynamic collapse of the supraglottic structures of the larynx resulting in airway obstruction

    • Most common congenital an...

DIAGNOSIS

HISTORY

  • Laryngomalacia

    • Symptoms may be present at birth or delayed until 1 to 2 months of age.

    • Inspiratory stridor

    • May be asymptomatic during sleep or quiet breathing

    • Worsens with crying, agitati...

TREATMENT

GENERAL MEASURES

  • Laryngomalacia

    • Most cases resolve spontaneously by 15 to 18 months of age.

    • Observation and reassurance

    • Consider feeding modifications (pacing, positioning, texture change).

    • Stron...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Monitor for recurrent respiratory symptoms, poor growth, and other exacerbating conditions (asthma, GERD). 

PROGNOSIS

  • In cases of isolated laryngomalacia and/or tra...

ADDITIONAL READING

  • Ambrosio A, Brigger MT. Pediatric supraglottoplasty. Adv Otorhinolaryngol.  2012;73:101–104. [View Abstract on OvidInsights]

  • Carter J, Rahbar R, Brigger M, et al. International ...

CODES

ICD9

748.3 Other anomalies of larynx, trachea, and bronchus 

ICD10

  • Q32.0 Congenital tracheomalacia

  • Q31.5 Congenital laryngomalacia

SNOMED

  • 95434006 tracheomalacia (disorder)

  • 253737007 Congenital laryngo...

FAQ

  • Q: When will the symptoms improve?

  • A: As anatomic structures mature with age, laryngomalacia symptoms may improve by 6 months of age, with usual resolution by 18 months of age. Primary tracheomalac...

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