Laryngomalacia

Visão geral 
Teoria 
Diagnóstico 
Tratamento 
ACOMPANHAMENTO 
Recursos 

Conectar-se ou assinar para acessar todo o BMJ Best Practice

Última revisão: 23 Sep 2025

Última atualização: 13 Dec 2022

Laryngomalacia is a congenital abnormality of the larynx cartilage that predisposes to dynamic supraglottic collapse during the inspiratory phase of respiration, resulting in intermittent upper airway obstruction and stridor.

Most common laryngeal anomaly and most frequent congenital cause of stridor in infants.

Natural history is presentation in early infancy with maximal symptoms at 6 to 8 months before gradual improvement and spontaneous resolution within 12 to 24 months.

Presents with inspiratory stridor. Some patients have upper airway obstruction with associated feeding difficulties. Frequently associated with GERD.

Diagnosis is made by the clinical features and with flexible laryngeal endoscopy. Direct rigid laryngoscopy under anesthesia may also be required. Possibility of additional airway lesions should be considered.

Treatment depends on disease severity; observation alone (with treatment of any associated GERD) is appropriate for most cases. Endoscopic supraglottoplasty may be required for more severe disease. Tracheostomy and pressure-assisted ventilation are other possible therapies.

Definição

Laryngomalacia (LM) is a congenital abnormality that predisposes to dynamic supraglottic collapse during the inspiratory phase of respiration, resulting in intermittent upper airway obstruction and stridor. LM is the most common source of stridor in infants and the most common congenital laryngeal anomaly.[1][2][3]

História e exame físico

Principais fatores diagnósticos

stridor
onset within 2 weeks of birth
features of airway obstruction
resolution of symptoms by 2 years of age
normal cry

Detalhes completos

Outros fatores diagnósticos

feeding difficulties
weight loss or failure to thrive
hypotonia
dysmorphic features

Detalhes completos

Fatores de risco

GERD
neurologic abnormalities
laryngeal anatomic abnormalities
male sex
genetic syndromic disorder

Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

flexible laryngoscopy

Detalhes completos

Investigações a serem consideradas

rigid laryngobronchoscopy
FEES testing
polysomnography
chest x-ray
lateral neck radiograph
ECG
echocardiogram

Detalhes completos

Algoritmo de tratamento

CONTÍNUA

mild disease

moderate disease

severe disease

Colaboradores

Autores

Simone J. Boardman, MBBS, FRACS (OHNS)

Consultant Paediatric Otolaryngologist

The Children's Hospital at Westmead

Sydney

Australia

Declarações

SJB declares that she has no competing interests.

Agradecimentos

Dr Simone Boardman would like to gratefully acknowledge Mr C. Martin Bailey, a previous contributor to this topic.

Declarações

CMB is an author of a number of references cited in this topic.

Revisores

Kevin Pereira, MD

Director

Pediatric Otolaryngology-HNS

University of Maryland School of Medicine

Baltimore

Declarações

KP declares that he has no competing interests.

Haytham Kubba, FRCS

Consultant Paediatric Otolaryngologist

Royal Hospital for Sick Children (Yorkhill)

Glasgow

Declarações

HK declares that he has no competing interests.

Gresham Richter, MD

Assistant Professor

Associate Residency Program Director

Otolaryngology - Head and Neck Surgery

University of Arkansas for Medical Sciences

Little Rock

Declarações

GR declares that he has no competing interests.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Olney DR, Greinwald JH Jr, Smith RJ, et al. Laryngomalacia and its treatment. Laryngoscope. 1999 Nov;109(11):1770-5. Resumo

Carter J, Rahbar R, Brigger M, et al. International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations. Int J Pediatr Otorhinolaryngol. 2016 Jul;86:256-61. Resumo

McCaffer C, Blackmore K, Flood LM. Laryngomalacia: is there an evidence base for management? J Laryngol Otol. 2017 Nov;131(11):946-54. Resumo

Yellon RF, Goldberg H. Update on gastroesophageal reflux disease in pediatric airway disorders. Am J Med. 2001 Dec 3;111(suppl 8A):78S-84S. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

Differentials
- Vocal cord palsy
- Subglottic stenosis
- Laryngeal web
Mais Differentials
Guidelines
- Laryngomalacia consensus recommendations
- New Zealand guidelines for the assessment of sleep-disordered breathing in childhood
Mais Guidelines
Patient information
Reflux in infants
More Patient information
Log in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer

Laryngomalacia

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

Outros fatores diagnósticos

Fatores de risco

Investigações diagnósticas

Primeiras investigações a serem solicitadas

Investigações a serem consideradas

Algoritmo de tratamento

mild disease

moderate disease

severe disease

Colaboradores

Autores

Simone J. Boardman, MBBS, FRACS (OHNS)

Declarações

Agradecimentos

Declarações

Revisores

Kevin Pereira, MD

Declarações

Haytham Kubba, FRCS

Declarações

Gresham Richter, MD

Declarações

Créditos aos pareceristas

Declarações

Referências

Principais artigos

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

Differentials

Guidelines

Patient information

Log in or subscribe to access all of BMJ Best Practice

Log in or subscribe to access all of BMJ Best Practice

Log in to access all of BMJ Best Practice