Congenital laryngeal stridor

Congenital laryngeal stridor (stridor laryngis congenitus) or laryngomalacia is caused by delayed development of the cartilages of the larynx (mainly the epiglottis), which leads to their abnormal softness. The epiglottis, together with the aryepiglottic folds, is sucked into the laryngeal inlet during inspiration, causing upper airway obstruction.

Clinical presentation
Clinically, it manifests immediately after birth or in the first weeks with inspiratory stridor. It can be constant or intermittent. As a rule, stridor is aggravated by crying, restlessness or infection. Congenital stridor is indicated by the fact that it is alleviated or disappears when the mandible of the child is pushed forward.

Definitive diagnosis is possible by laryngoscopy.

Diferencial diagnosis
In the first days, it is important to distinguish between neonatal tetany or secondary laryngeal edema after trauma. In addition, extraglottic causes (macroglossia, glossoptosis) and other laryngeal malformations (diaphragm laryngis, synechiae, subglottic stenosis, cysts, articular ankylosis), paresis of the recurrent larynx, laryngeal tumors, external stenoses (congenital goiter, anomalous vessels).

Treatment
Specific therapy is not necessary, for children the elevated position is preferable (especially during feeding). In most cases, it adjusts spontaneously within a year.

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