Laryngomalacia, or noisy breathing in infants, is the most common reason for a newborn to have stridor, or noisy breathing. The stridor is typically inspiratory, and is worse when the baby is on its back. Laryngomalacia is characterized by an omega shaped epiglottis, short aryepiglottic folds, and redundant mucosa of the arytenoids. Surgery is indicated when the stridor is severe enough to impact breathing or when the baby is not gaining weight due to this issue. Surgery is relatively simple and first involves a bronchoscopy, or an evaluation of the lower airways, to make sure nothing else can be the root cause of these issues. Palpation for a laryngeal cleft is also performed. Once it is determined that laryngomalacia is the primary etiology, the aryepiglottic folds are incised with microscissors and redundant mucosa of the arytenoids is trimmed. Patients usually do very well after this procedure, and if there are no other problems, are able to breathe well and gain weight.
Mark S. Courey, MD Chief, Division of Laryngology Director, Grabscheid Voice and Swallowing Center of Mount Sinai Vice Chair of Quality, Department of Otolaryngology Mount Sinai Health System
Diana N. Kirke, MD Assistant Professor, Otolaryngology, Head and Neck Surgery The Mount Sinai Hospital
Matthew C. Mori, MD Assistant Professor, Otolaryngology New York Eye & Ear Infirmary of Mount Sinai
Zachary G. Schwam, MD Assistant Professor, Department of Otolaryngology-Head and Neck Surgery Division of Otology-Neurotology, Lateral Skull Base Surgery Mount Sinai Health System
