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Laryngomalacia Workup

  • Author: Stephanie Lovinsky-Desir, MD; Chief Editor: Denise Serebrisky, MD  more...
Updated: Jun 18, 2015

Laboratory Studies

Oxygen saturation should be monitored in patients with laryngomalacia.


Imaging Studies


  • Fluoroscopy of the airway may be performed by a pediatric radiologist.
  • The cartilages may be observed collapsing on inspiration on a lateral view of the airway.

Laryngoscopy and bronchoscopy

  • These studies are the best studies used to confirm the diagnosis. However, in an infant with typical inspiratory noises (worse when supine) who have a normal cry and normal growth and development, clinical diagnosis is not unreasonable.
  • A pediatric pulmonologist or pediatric otorhinolaryngologist may perform flexible laryngoscopy or bronchoscopy. Bronchoscopy under anesthesia has been shown to be more sensitive and specific than bronchoscopy in infants who are awake.
  • Direct visualization of the airway reveals an omega-shaped epiglottis that prolapses over the larynx during inspiration.
  • Enlarged arytenoid cartilages that prolapse over the larynx during inspiration may also be present.
Contributor Information and Disclosures

Stephanie Lovinsky-Desir, MD Assistant Professor in Pediatric Pulmonology, Morgan Stanley Children’s Hospital of New York-Presbyterian, Columbia University College of Physicians and Surgeons

Stephanie Lovinsky-Desir, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO Professor, Chief, Department of Pediatrics and Pediatric Pulmonology, Tripler Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Chief Editor

Denise Serebrisky, MD Associate Professor, Department of Pediatrics, Albert Einstein College of Medicine; Director, Division of Pulmonary Medicine, Lewis M Fraad Department of Pediatrics, Jacobi Medical Center/North Central Bronx Hospital; Director, Jacobi Asthma and Allergy Center for Children, Jacobi Medical Center

Denise Serebrisky, MD is a member of the following medical societies: American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

Michael R Bye, MD Professor of Clinical Pediatrics, State University of New York at Buffalo School of Medicine; Attending Physician, Pediatric Pulmonary Division, Women's and Children's Hospital of Buffalo

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society

Disclosure: Nothing to disclose.

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Laryngomalacia: The epiglottis is small and curled on itself (omega-shaped). Approximation of the posterior edges of the epiglottis contributes to the inspiratory obstruction. (From B Benjamin, Atlas of Paediatric Endoscopy, Oxford University Press, NY, 1981, with permission.)
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