Laryngomalacia

Descripción general 
Teoría 
Diagnóstico 
Manejo 
Seguimiento 
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Última revisión: 12 Aug 2025

Última actualización: 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.

Definición

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]

Anamnesis y examen

Principales factores de diagnóstico

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

Todos los datos

Otros factores de diagnóstico

feeding difficulties
weight loss or failure to thrive
hypotonia
dysmorphic features

Todos los datos

Factores de riesgo

GERD
neurologic abnormalities
laryngeal anatomic abnormalities
male sex
genetic syndromic disorder

Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

flexible laryngoscopy

Todos los datos

Pruebas diagnósticas que deben considerarse

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

Todos los datos

Algoritmo de tratamiento

En curso

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

Divulgaciones

SJB declares that she has no competing interests.

Agradecimientos

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

Divulgaciones

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

Revisores por pares

Kevin Pereira, MD

Director

Pediatric Otolaryngology-HNS

University of Maryland School of Medicine

Baltimore

Divulgaciones

KP declares that he has no competing interests.

Haytham Kubba, FRCS

Consultant Paediatric Otolaryngologist

Royal Hospital for Sick Children (Yorkhill)

Glasgow

Divulgaciones

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

Divulgaciones

GR declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

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

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. Resumen

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

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

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales
- Vocal cord palsy
- Subglottic stenosis
- Laryngeal web
Más Diferenciales
Guías de práctica clínica
- Laryngomalacia consensus recommendations
- New Zealand guidelines for the assessment of sleep-disordered breathing in childhood
Más Guías de práctica clínica
Folletos para el paciente
Reflux in infants
Más Folletos para el paciente
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El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad

Laryngomalacia

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

Otros factores de diagnóstico

Factores de riesgo

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

Pruebas diagnósticas que deben considerarse

Algoritmo de tratamiento

mild disease

moderate disease

severe disease

Colaboradores

Autores

Simone J. Boardman, MBBS, FRACS (OHNS)

Divulgaciones

Agradecimientos

Divulgaciones

Revisores por pares

Kevin Pereira, MD

Divulgaciones

Haytham Kubba, FRCS

Divulgaciones

Gresham Richter, MD

Divulgaciones

Peer reviewer acknowledgements

Disclosures

Referencias

Artículos principales

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales

Guías de práctica clínica

Folletos para el paciente

Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice

Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice

Inicie sesión para acceder a todo el BMJ Best Practice