Pediatric Congenital Laryngeal Stridor / Laryngomalacia

Congenital laryngeal stridor is a defect that is present at birth. During fetal development, the structures in the larynx may not fully develop. As a result, there is a weakness in these structures at birth, causing them to collapse during breathing. In children, congenital laryngeal stridor is the most common cause of chronic stridor. 60% of infants born with congenital laryngeal stridor will have symptoms in the first week of life. Most other infants will show symptoms by 5 weeks old.

The major symptom of this disorder is the stridor that is heard as the infant breathes. The stridor is usually heard when the infant breathes in (inspiration), but can also be heard when the infant breaths out (expiration). Other characteristics of the stridor may include:

• The stridor changes with activity.
• The stridor is usually less noisy when the child is laying on his/her stomach.
• The stridor gets worse if the infant has an upper respiratory infection. The symptoms of congenital laryngeal stridor may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

In addition to a complete medical history and physical examination, diagnostic procedures for congenital laryngeal stridor may include bronchoscopy of the airways — a procedure which involves a tube being passed into the airways to allow your child's physician to observe the airways during breathing.

In most cases, congenital laryngeal stridor is a harmless condition that resolves on its own, without medical intervention. The condition usually improves by the time the infant is 18 months old and has no long-term complications. In some cases, the stridor is apparent until about the age of 5. Each child's case is unique. About 10 to 22% develop severe respiratory problems which require medical and surgical interventions.