Laryngomalacia: review of current evidence and considerations

Stridor is an alarming symptom for the pediatric population with a prevalence in newborns due to the anatomical features of the airways. Laryngomalacia (LM) is the main etiological cause with a frequency ranging between 45% and 75% according to different sources. The aetiology of laryngomalacia has not been defined—there are several theories that can be classified into two main groups—anatomical and neurological, neither of which is universally accepted. The criteria for diagnosis are not standardized—required is endoscopic registration of inspiratory supraglottic collapse in the presence of clinical symptoms. However, some of the endoscopic features of the condition have also been found in healthy patients. The standard approach to а mild and moderate form is an observation for 12-24 months. Spontaneous resolution of symptoms is usually observed during this period. The severe form affects 10-20% of the patients. It is characterized by a severe clinical picture that does not improve spontaneously. These patients require further examination to rule out a secondary airway lesion or require surgical correction of LM.