Laryngomalacia

Laryngomalacia literally means ‘abnormal softening of the larynx’
It is a congenital condition in the supraglottic part of the larynx is abnormally flaccid
It is the most common congenital lesion of the larynx and is the most common cause of congenital stridor
During inspiration, the epiglottis folds upon itself and is sucked into the larynx
This causes stridor and sometimes cyanosis
The severity is more when the child is crying and is relieved by placing the child in prone position
It appears at or soon after birth and usually disappears by 2 years of age
Diagnosis is by laryngoscopy (direct / flexible)
An elongated epiglottis which is folded upon itself (in the shape of an omega when viewed from above – omega sign)
In a lateral x-ray film, the epiglottis appears thumb shaped (rather than the usual leaf shape)
Treatment is mostly conservative
Severe respiratory obstruction may require tracheostomy