Laryngomalacia Workup

Updated: Feb 12, 2019
  • Author: Stephanie Lovinsky-Desir, MD, MS; Chief Editor: Denise Serebrisky, MD  more...
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Workup

Laboratory Studies

Oxygen saturation should be monitored in patients with laryngomalacia.

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Imaging Studies

Fluoroscopy

  • 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.

 

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Procedures

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.

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