Children's Hospital Colorado

A Case Study on Laryngomalacia in Infants and Children (S2:E11)

Laryngomalacia refers to the softening of the tissues above the vocal cords. Babies with laryngomalacia suffer from a malformed laryngeal structure, which causes the tissues to fall and partially block the airway. It's the most common cause of noisy breathing in babies and is often apparent when the baby is lying on their back. Since the causes of laryngomalacia are congenital, babies are born with the condition.

In most cases, laryngomalacia in infants is not a serious condition and the noisy breathing does not lead to problems with eating or growth. However, a small percentage of babies with laryngomalacia will struggle to breathe adequately, eat properly and gain weight at a healthy rate. These laryngomalacia symptoms require immediate emergency medical attention.

Listen to pediatric aerodigestive experts discuss laryngomalacia

In today's episode, we're examining the case of Rachel, a baby who presented with laryngomalacia. The case started in a primary care pediatrician's office and ended in the Children's Hospital Colorado Aerodigestive Program.

Joining us are the three physicians involved in the patient's care: Larissa Applegate, MD, a pediatrician at Pediatrics West in Wheat Ridge, Colo., Ryan Caltagirone, MD, a pediatric emergency room physician at Children's Colorado and Sven Streubel, MD, an otolaryngologist with Children's Colorado.

In this episode, our three guests:

  • Examine their roles in the baby's laryngomalacia care and share key takeaways to inform other medical professionals
  • Explore the origins of the case, including the laryngomalacia symptoms baby Rachel first presented in the hospital
  • Explain the steps taken once Rachel's respiratory struggles were evident and the next steps to get her to the Emergency Department
  • Touch on the importance of clear communication between departments and with patient families in complex, multidisciplinary cases
  • Talk about approaching a patient who presents with laryngomalacia from an ear, nose and throat (ENT) perspective
  • Explain how to use a bedside scope to determine the severity of the laryngomalacia
  • Reflect on the various elements of Rachel's multidisciplinary care, including the admission procedure, observation of feedings, continued oxygen support and next steps
  • Share guidance on common medical treatment plans for babies with laryngomalacia
  • Explain how to develop a long-term management plan for a child with laryngomalacia that equally supports the patient and their family
  • Explore the most common comorbidities that come along with laryngomalacia
  • Provide an update from the patient, plus key takeaways from the case

Diagnosis and treating laryngomalacia in infants at Children's Colorado

Babies with aerodigestive issues, including laryngomalacia, are treated by the Aerodigestive Program at Children's Colorado. Our pediatric experts are dedicated to providing comprehensive, state-of-the-art evaluation and management for infants and children with complex airway, respiratory and gastrointestinal tract disorders. Refer a patient to Children's Colorado.

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