Laryngomalacia - What is it, what are the symptoms, how is it managed
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- Опубліковано 16 тра 2019
- Laryngomalacia - What is it, what are the symptoms, how is it managed
Laryngomalacia "floppy voice box"
Can cause stridor - musical sound, usually when breathing in
+/- retractions - tugging or collapse of neck and chest with work of breathing
Most common cause of stridor in newborns and infants
Usually will outgrow the issue
Can cause or exacerbate reflux
Which in turn can make the breathing and noise worse
May need to modify feeding
- propped up during and after feeds
- smaller, more frequent feeds
- loose diapers, avoid tight waisted clothing
- consider thickening milk/formula if bottle fed
- burp frequently
If there is difficulty with weight gain and/or significant distress, may benefit from reflux medications like Pepcid, Zantac, Prilosec, Prevacid
If worsening despite medications and feeding modifications, may require surgery (rare - less than 10% of cases)
Medical Disclaimer: All comments are generalizations and intended to be for educational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
By far, the most instructive video on youtube describing the condition of Laryngomalacia for a parent.
Explained it better than my doctor did!!
This is the only video that helped me while I was freaking out about my newborns breathing thank you!
Your video was so helpful to have a closer and better yet simple understanding for children having this case, thank you for sharing and helping.
God please protect all the children in this world
Not happening with Israel is there
He doesn't
Wow. I love your films. It’s very helpful for me as a medicine student. Please, do more! :)
thank you Dr. Liu, the video is not only illustrating but extremely helpful .I had no idea of this condition.
Very thorough, thank you!
My child has larynomalacia! Due to its complication sometime he gets pneumonia! He also suffered from asthma. Doctor says he will improve after five years but he is 4 years! As a father i could not never sleep at night peacefully since his birth.Hope he will get well soon.My personal life is also disturbed too much that i can't concentrate in my work. During office time and all time my mind goes to him.
Very helpful. Thank you!!!
Very informative. Thank you
Brilliant videos
Thx doc. Very helpful..
Thank you !! 🙏🏻🙏🏻🙏🏻🙏🏻
Thanks for valuable information doc
Thank you so much doctor
very nice and useful contenent
Very helpful. Thank you for taking the time to make this. #newdad
Thanks a lot from India
My son did an surgery when he was a baby. Your video has an amazing explanation. So important for fathers and mothers that have kids with laryngomalacia.
Agree, my son 5months old going through now since he was 6weeks old.
Hi, my son is only 5 days old and has floppy Laryngomalacia, what age was your son when he had to have surgery?
Its horrible sound, spec when the have a little cry and can't catch their breath :(
Thank you
Ben
@@benharrison8564 hi my son also having same prblm day by day his sound s increasing..can't feed properly..being a mother I'm very much worried but Dr said it's normal..
Wen I get resolve..I wanna his breathing prblm to be resolve he have to be breath like normal infants.
My son is 4 months now, and it's amazing how much it has got better, I don't even hear it anymore, i know its hard but try not to worry to much it will get better.
thank you doc from the Philippines
My 14 year old had it. It was so scary for me. He did have severe acid reflux and the sound was always worse before he vomited after feeding. He took medication for acid reflux until he was around 6 months old and he grew out of the scary breathing sounds before he was 18 months old just like his ENT said he would. I wish that I would have known more about it back then. I quit my job and everything became I was so scared to leave him. Now I can't wait to go to work. Teenagers lol
At what age he get ride of LM
@amirali6218 before he was a year old, I don't remember. I don't think that I noticed when it went away until I realized that it was gone. He saw a specialist when he was a newborn and she said that it should go away around the age of 12 to 18 months and it did.
Thank u so much am very worried about my one month daughter she has LM she is on mother feed Dr said mother feed is best for her but I read so many comments here that formula is best for LM baby
Its helpful
Thank you for the insight explanation.
My son is going through since birth, he had MLB done, unsafe swallow after he had MLB, now he's 5 months old. He is NG tube feed and small feed milk with thickner. Also he has reflex very sever one. Is very devastating seeing your child breathing very abnormal.
Hope your child get well soon and see him breathing normal again.
Thank you so much for your video. It was very helpful to understand about LM which my baby is struggling with. I did not let her take the scope but the doctor said that she might have mild LM. I also think that it is not severe because I cannot hear the sound you mentioned in the video. However as she is turning to 70days old, she is more suffering because of the phlegm. It seems the phlegm is stuck in airway and makes her uncomfortable and cough. Even during she is sleeping, she tries to move her head and neck to clear her throat like every 5 minutes so she cannot sleep deeply everyday. Her doctor said if the symptom is mild, it tends to be cured faster like 100 days after. So I would like to believe that this phlegm problem is caused because her larynx is developing.
She probably has reflux
I had to get surgery when I was 2 months because of that. My parents went to many different doctors and they didn’t know what to do with me. After seeing a lots of doctors, they managed to find the good one and immediately took me to the urgency. I was diagnosed with severe Laryngomalacia and they managed to do the surgery very well.
How old are you now ? How you feeling after surgery and any complications after the surgery?
My daughter has now got it at 4 months old. Hope it's not severe
@@compassion333 good day to you...im from Philippines...have 3mos.old baby have same case...i used to search from google as well youtube..have peace of mind now coz i find out its common for babies..
@@maheertv6796 I never heard of it before and didn't know it was common. My daughter started having it 2 weeks ago and I sent a video of her to the doctor. The doctor said she might have laryngomalacia. Right now it's not severe hope it stays this way.. looking to your name I thought you was from Turkey 😄
@@compassion333 yeah its common and none treatment...undergo surgery are only rare case...kindly check from google...
Yeah ur right Actually i got this name from Turkish series if not mistaken title was Ask Laftan Anlamaz...Hayat Pektas was the lead Actress😊
My child was given “SUPRAGLOTTOPLASTY” in error. He didn’t have “Laryngomalacia” he had “Tracheobronchomalacia” with OSA (grade 4 tonsils) taken to OT for adenoid/tonsillectomy. Went to ICU post theatre as UNABLE TO maintain own airway. / staying on highflow post intubation in OT. He was admitted 32 days in a tertiary childrens hospital… Mum escalated care being a ED RN it was abundantly clear something was wrong. Sleep study test post OT became “severe” OSA “12 AHI/ HR” (3 weeks post & 2 days prior to OT he was “unremarkable in sleep study). He developed BRADYCARDIA (60BPM sustained ever since!) ELEVATED JVP +++ (right sided looks like it will burst in sleep when unwell or INSPIRATORY STRIDOR +++ in progress! Every sleep since “DIAPHORETIC” +++, WOB +, LOUD significant respiratory distress/abnormalities observed “head bobbing”, re-session in intercostal/ SUBSTERNAL/
Tugg +++++
He was diagnosed has now having “a laryngomalacia” with Supraglottic stenosis/collapse (13 months old in errored surgery). Now aged 2.5 years & HE IS STILL SYMPTOMATIC actually progressing/ worse.
It cannot he “laryngomalacia” as sitting upright or left/ride side laying ARE HIS MOST WORSE OBSERVED & concerning respiratory distress positions. To the point i was told to keep him upright for significant “laryngomalacia” observed in FNE 3 weeks post OT. All of which advised to watch/wait he should grow out of it & the SUPRAglottic stenosis/ collapse. He hasn’t to date & instead it’s progressing to me? Due to his speech = +++ unable to understand him myself (ENT cant either yet said SPEECH is not related to ENT conditions like in his case i questioned the links?) advised to sleep him in car seat since age 13 months on D/C
that’s his most unsafe WORST time to sleep!
Further advised ENT his stridor is instant on any head down tilt like that of needing a jaw thrust= stridor then gone. However
kids his age are not in my resus experience needing “Jaw Thrust” instead that would normally cut the airway off! (My resus experience/ ED experience for peads is solid in the “no peads ward or peads specialist specific trained Drs/Nurses” instead as I don’t have tertiary hospital exposure/ experience nor the staff specialists iv discovered how much we don’t know at my hospital. In addition; makes so much sense why not one ENT detected how significant he was. Nor did ENT seem to know anything about airway malacia. As i wss originally advised Tracheomalacia MILD no treatment ever required & or concerns needed. Advised “Non pulsatile”. So when the bigger he grew the WOST he became deteriorating into a pneumonia hospitalised for near 2 weeks before the ERRORED surgery. . He sounded like he was drowning on his own fluids all of which in lungs as he was like a CF kid to me! Excessive secretions & no one listened to me “labelled parental anxiety!” Zero due diligence occurring!!!
Turned out i was right! Found to have mod/severe TRACHEOMALACIa= PULSATILE (aortic innate arch branch left sided). Nil trachea structure damages. However compression up to 70% when “well”. His CT intubation you can not see anything but sml tube going down AIRWAY onlu open due to it! The as they progressed into lower end of trachea & bronchs / lungs +++ space around this airway ETT tube. Indicating to me significant upper airway narrowing! (Tracheobronchomalacia) treated hypertonic saline nebs BD + staff specialist prescribed antibiotics for myself & staff member for incase we contracted same & unaware to date.
Iv advised ENT this cannot be laryngomalacia he one (never had it). 2) all started post op! Low oxygen.. Then few weeks later LOUD INSPIRATORY STRIDOR IN SLEEP. Worse SITTING UP RIGHT &on his side.
He should be at his BEST if laryngomalacia sitting updight! He cough/choke/gag diarheAches +++ of late. When STRIDOR & when at rest! Like a swallow eat speak breathing gag reflex occurring. Confident its not aspiration = untrained eyes looks VERY SIMILAR he just does it on his own sections/ AIR not food.
Speechie had him on thicker NO DIFFERENCE. He had testings that evidenced NO REFLUX & no SPEECH NERVES COULD BE AFFECTED AS ENT SAID NEVER BYPASSED THESE OR TOUCHED THEM. (This ENT also choose to do ERRORED SURGERY leaving a baby dr to operate on a BABY is so dangerous!!! He isn’t suppose to leave or be unsupervised or supported!!! I was never given open disclosures this occurred. (The hesd od ENT department told me in private rooms it happened. Yet he won’t put it in offical written documentation of my son’s?! Advising he can’t his career will be destroyed like others who spoke out on EXACTLY SAME ISSUES!
Any suggestions or advice you have on what this could be? (Supraglottic stenosis/ collapse) to me seems to be the main diagnosis/ issue / cause ?
Its also caused by supraglottoplasty alot in papers i read.
Concerns the tertiary hospital dont / wont allow accurate diagnosis until they believe time is up for lawsuits… Due to it gone on nonstop in staffs documentation were they are made to do it infront of people/ they read it & approve its SIGNED prior to it being automatically signed off!
In my world we open disclose! Its the right thing to do! I therefore won’t be pushed into bulling tactics to stop him getting a diagnosis they state will only be used for lawsuit (to other MO’s kj this case as they told me directly!)
Hospital hasn’t released to me under GIPA/ freedom of information requests his;
1st physican PSY sleep study test RESULTS post OT
2nd VIDEO/photo documentation of his (1st & 2nd OT) or his x2 NASOSCOPES (currently in progression of escalation to have same overturned as they msking out they don’t exist! They do iv seen them uploaded!)
= this all can’t he a coincidence. Instead delaying my son’s accuracy & early intervention/ detection SAFETY.
Any thoughts whatsoever on what his airway issue is / or can be please comment a reply!
Noting; never have I ever experienced such medical malpractice & low standards of health care delivery then this 1st year ENT consultation / management. My son isn’t the only case yet no one’s reporting or reported him. He appears WELL SUPPORTED even by thos he doesn’t even know!
Thanks so much in advance
Happy for private emails/ conversations instead of here publicly if you too preferred same?
He is awaiting emergency list opening or cancellation for MICRO LBO from any day from now.
Thankyou
Thank you 😊 for sharing your knowledge Doc. My baby was born with similar problems buy the pediatrician confused it with Pectus excavatum. I see him making the same noise like the baby u shared with whistles. How do I convince her otherwise? How similar are this two conditions ?
Thank you for this video. My daughter has LM and I see that when it acts up, she does have retractions. Are these retractions an emergency or is this a normal side effect of stridor?
Sir can u describe more regarding areytnoid mucosa ND aryepiglotic folds while doing laryngoscopy ?
My son was diagnosed with this at 3months old.. he is now 4 yrs old and still hasn't grown out of it.. every year he gets sick with a cold and the sound comes back very loud..this yr he's been sick since June and he's starting to gag and almost sounds like he's choking but he eats well, overall healthy its just that noisy breathing & his cold lasting longer & longer every time he gets it every yr.. I am so frustrated feeling like I'm not getting any answers, please tell me what you suggest or if u have seen kids a 4yrs old still having it
My son premature and he has mild laryngomalacia. Ent doctor give my son syrup omeprazole. Thank you for this video.
How long does it take to go off by the ahe?
My daughter was diagnosed with LM at 3 weeks old and suspected of having TM. We were told she would grow out of it by 2. She did seem to get better until shortly after her 5th birthday. She started sounding winded and she started having a tracheal tug again. We saw the doctor and he said it was TM, but never did anything to confirm. She is getting worse in my opinion. Since she started kindergarten she has lost weight (about 7 pounds), been to tired to go back to class after recess or PE on occasion (enough that the school is limiting her recess and PE). She will crash at night on days she has dance or goes swimming. She sounds winded everyday after school. Some days her breathing is loud enough for everyone to take notice but she hasn’t done any physical activities. She does have a tracheal tug. The doctors brush it off and say she is fine. Am I right to be concerned or am I over worried?
I think you’re over-worried.
My kid has Laryngomalacia. Is pulling in and out around the neck region one of the symptoms of Laryngomalacia? Does it equally likely go away with time?
My son was diagnosed with layryngomalacia. He will be 5 years old in April. Although he's doing better with his breathing, I'm still concerned with his weight because I was told he will be gaining weight from age four but that is not happening. Pls any advice. Thank you
My 5 1/2 year old had this as a baby and grew out of it. Now I have a 5 week old and I don't hear the stridor noise, but she makes a ton of grunting noises as if she's trying to clear her throat and it always sounds horse. She was born at 38 weeks and was 5lbs 13oz. In 4 weeks she was up exactly 2lbs, she breast feeds well and is gaining weight nicely, but I'm wondering if the constant grunting, throaty noises she makes that I hear especially after feeding could be the same thing or if it's likely more just reflux?The horseness in her voice is what really makes me question that there is something more going on than just reflux. I'm starting to cut dairy from my diet and we are hoping to see an ENT next week...
It may very well be reflux, and it could be other things as well. Your best bet is to see the ENT.
Ahhh my both children .. its really painful to see your children 💔
I have a newborn I attended to today and didn't know how to diagnose. Upon my searches I've found out that it's laryngomalacia but mild. Baby is not in respiratory distress, breastfeeds normally and saturates well. Us there something I can do?
Hello, can you please make a video on hearing problems ? Thank you 😊
Hi Doc. Thanks for your sharing again. As for my baby actually hospital arrange for my baby's operation but at last didn't make. I have confirm with the hospital that my baby have to put under tube feeding because of scares of milk enters the lungs and scared that my baby get choke and turns blue. They say they put it for In Case.. Now my baby is 4months old already didn't get under the immunisation for 3months already, hospital insists that baby is still under treatment cannot go under immunisation. Actually I'm really lost directions about my baby's sick.. The hospital also mentioned that floopy voice box needed to be stitch.
Also I want know that baby normally have like this case how to know if getting worst and when or how long will it get recovery normally? Please guide Doctor.
Hello sir my baby is a 2month old..he is suffering from this LM ...his birth weight is 2.5kg nd now 4kg ...sleeping well but with sound ...is that normal
In a nutshell can airway stenosis cause swollen Turbinates one sided in paediatric cases? Turbinates that go up & down up to 95% one side occluded.
Why is this not something occurring with significant WOB/ respiratory distress/ supraglottic stenosis/ collapse with raised +++ JVP
Or post supraglottoplasty/ larynx surgeries re; STRIDOR/ JVP one sided with Turbinates one sided +++ swollen
Is it normal ie not a concern ENT should be investigating further especially as new symptoms the Turbinates for example?
These cases post supraglottoplasty get diagnosed as a acquired laryngomalacia they’ll then grow out of advised. Yet a professor here states untrue they need epiglottic repositioning (ENTs are getting paeds cases wrong causing problems in some kids).
These cases how to do navigate this? What’s right/ wrong? True or false on supraglottoplasty in particular if they didn’t actually require this surgery. Or ENT junior drs took off to much mucosa BILATERALLY. Does this repair? What age length should be expected in kids who didn’t have laryngomalacia previously/ prior to this surgery? Yet Anatomy now apparently similar to it? Classified as laryngomalacia…. Then other records Supraglottic stenosis/ collapse.
Why if a supraglottoplasty occurred would they have documentation stating “the most recent laryngoscopy was reviewed & i can see there is significant anterior & posterior constriction at the level of epiglottis to the arytenoid tissues” >>> yet these babies had “supraglottoplasty” that was not required when sent to a professor in tertiary hospital. However the above is why i find ENT so hard to navigate the understandings regardless of the excessive research i put in trying to improve on my understandings/ assessment/ knowledge.. . I would think the above statement would be in cases that didn’t get the supraglottoplasty yet apparently they did. Instead needing epiglottic repositioning if not outgrown … One case I know was 3 still stridor ++++ occurred in sleep. Another was an adult tho who had epiglottic repositioning & failed = tracy needed.
Alot of kids having trachys post if epiglottic repositioning fails. When should parents know watch / wait is over? Surgery is needed? Surely ENT are all trained in the same area’s ie supraglottic stenosis/ collapse for example? We’ve been Told its so rare this is why isn’t “so misdiagnosed “.
Another question can these surpraglottic stenosis cases cause tracheomalacia? Or Tracheobronchomalacia? Or make these cases worse (longer duration ie up to 43 cm longer?)
I just feel in my gut something is off that we might be missing. Could they have subglottic & supraglottic stenosis? TheSUB glottic MAKES sense to me as to why “structual of tracheas normal yet its so progressive since these surgeries in some, (kids were lungs scarred/ collapsed= pulsatile innate arteries).
Iv seen no case that case “worsening airway malacia” unless these supraglottic stenosis/ collaose cases.
I know now very well its 100% upper airway stridor on inspiratory breathing. No expiration breathing noises which isn’t that what tracheamalacia is? Only time biphasic I’ve observed was the child in respiratory distress with HMP needing hospitalised admission for that virus (severe OSA yet doesn’t need CPAP).
Your understandings are clearly my blessings needed to put me out my misery! Iv watched so many webinars/ pod casts & wish someone would just cover these topics like yourself for people like us > even parents as nothing exists on it all in one place.
Your videos are so easy to understand that i ve learned something in all. Even ones i went to skip thinking to basic! 😂
My interests are airway/ breathing/ circulation of ENT +\_ emergencies & obviously paediatric patients advocacy where needed relies on us understanding it first so here i am to be your biggest youtube fan or pest? On these topics seems only suitable for yourself so far to give clarification upon.
Thank you in advance most appreciated
Ny baby is born with that sound until now he is 9 months old I’m always worrying about it
If you're baby is gaining weight and growing, it's a good sign. If you are worried, you should definitely see an ENT that is well versed in the care of young pediatric patients.
सर बच्चे को Laryngomalacia
नाम की बीमारी है वजन कम बढ़ रहा है उसका वजन कैसे बढ़ेगा अभी वह 7 महीने की है
My baby has still same problem.. now he is 6months old
But my doctor didn’t give any medicine
It usally resolve by 2 years of age, so management is usally is conservative by reassurance, supraglottoplasty is done only when stridor is very severe
Hi doc.. My baby is a month old.. I can hear that gushing sound while feeding. He seems to be normal rest of the time.. He was born at 37 week and he was 2.2kg and now he is 3.1kg. He is gaining weight. But this sound while feeding breast milk or formula is causing me more worry.. I actually thought its phelgm that's like chest congestion. My doctor said some babies larynx take time to develop and it should settle on it own. But I feel that my baby is having hard time. Plz suggest me what to do next?
The only thing that I can suggest is to see a Pediatric ENT to have it evaluated. Best of luck!
Hi did the sound reduced as my son also having same problem 3 month baby
Is this more common in preterm children?
I read that it is
Hi doctr. My baby is 1 month old I can hear that noise while breast feeding,he is choking so many times in a day and he spits alot of milk as well he breathes fast but during sleep and most of the times he is normal, but he is gaining weight plz reply me what is it.
Me too
Ap ka baby sai hy
Kesini gara gara ustz OKI Setiana Dewi, baby Sulaiman
♡♡♡♡
My baby have laryn gomalacia. He is 2 months old. What should I do now? What’s the treatment of laryn gomalacia? Please let me know.
A lot of times, no treatment is necessary. Sometimes it helps to do some feeding modifications and positioning. Sometimes medications can be helpful. Only rarely is surgery required. Only your doctor can tell you about your situation. Good luck!
Gene Liu, MD, MMM thank you sir. Sometimes he have breathing difficulties, he can’t breath normal. Is that any problem with that. How long it takes for recovery?
@@shojibislam9933 For both of you. Thank you Dr. Liu for an excellent video. My grandson is 12 weeks and 1200 miles away. I only see him on Facetime because of COVID19. I've been extremely worried because he sounded severe to me. His mom took him to 3 pediatric ENTs and finally the 4th one 2 days ago recognized that he was severe and did a laryngoplasty yesterday. I see the improvement in his breathing, his alertness, and feeding already! And he just left the hospital an hour ago.
@@GeneLiuMD Written a big comment re; what can be the diagnosis if “SUPRAGLOTTOPLASTY” occurred In ERROR! = respiratory distress resulted into ICU admit directly from recovery .. 32 day admission thereafter.
“Diagnosis supraglottic stenosis/collapse”
Now diagnosis “significant Laryngomalacia” keep upright etc. told supine will be his worse respiratory symptoms etc . Iv told them over a year its POLAR opposite he can’t stay in car seat asleep like they want as significant respiratory distress & tirring & diaphoretic occurs from HEAD BOBBING STRIDOR/ accessory muscles overuse TUGG & WOB
His best position is laying down not elevated! Especially compared to sitting upright
Any head slight tilt downwards = ++++ INSPIRATORY STRIDOR / WOB 1-100 STAT PROGRESSION as a result.
Laryngomalacia is a congenital issue this is a OCCURED post OT issue!
Error surgery age 13 months on 10th june 2021!
It’s getting worse & worse needs hospitalised every respiratory virus since EVERY SINGLE MANKY YET NORMAL ONE & steroids as he can’t maintain his airway patent or ability to breathe on own. Needs support for oxygen EVERYTIME
It can’t be this hard to work out? Surely
what if u still have larygomalica and u are 13
It is certainly rare, and usually mild if it is present. Depending on the situation, it may be best to leave it alone, and there are times where we do procedures when there are enough problems.
well I have had 7 operation mite be having my 8 nexted year
@@shakirarandall2693 - that's unfortuate. Sorry to hear that you are going through all of that. Your situation is exceedingly rare.
Daughter started showing larygomalacia symptoms at seventh age like noisy breathing when excited.Doctor detected it too.She was normal these 6 months.It started suddenly.Is it worseing?
I'm sorry. I don't really understand your comment/question. What age is she now? What age did the symptom start? What age did it worsen?
It's impossible to say. I would suggest going back to the doctor in order to find out what is going on.
Hey doc am a new mum and my son has this condition and spitting alot what should I do
Hi doc , im a new mom my baby is 1mos old in few days he will be 2mos. i bothered the way he breath like you might think he has an asthma until it went out then back again...so i went to his pedia and examine him and i record the way he breath...the pedia says its laryngomalacia and says its common for the babies but need to monitor his breathing..as i monitor seems like its not bad as before however it continue when he sleep at night. what should i do tho coz im really bothered and worried and his gaining weight as well. thank you in advance for your answer
Kelly Curt Gaspar my baby has the same problem, he just turned two months old
Did you guys get any help? My baby just turned two months and I think he has laryngomalacia as well. We have an appointment with his pediatrician on the 15th but I’m worried
Welp he Quit UA-cam So
So helpful! Thanks