Laryngomalacia in the older child: clinical presentations and management

Abstract

Purpose of review: To review the literature on laryngomalacia that manifests in older children and contrast this with congenital laryngomalacia seen more prevalently in infants. In doing so, we hope to offer relevant diagnostic and management options to treat late-onset laryngomalacia based from our experience and the current literature.

Recent findings: Laryngomalacia in older children can present differently than congenital laryngomalacia, and the most common and best understood consequence of late-onset laryngomalacia is obstructive sleep apnea syndrome. Other manifestations include exercise-induced stridor and possibly even dysphagia. When the diagnosis is properly made and the etiology is isolated to the larynx, supraglottoplasty can be an effective treatment option.

Summary: Compared with congenital laryngomalacia, the diagnosis and management of late-onset laryngomalacia is not as well defined. Few articles have addressed this condition directly, and more research is needed to better delineate how it presents and how it should be diagnosed. Finally, its treatment options, including the role of supraglottoplasty, need to be better understood.