Role of tracheostomy in laryngomalacia

Saraiza Abu Bakar
Sultan Idris Shah Hospital, Serdang, Selangor, Malaysia

Background
Laryngomalacia is the most prevalent congenital laryngeal anomaly and the leading cause of inspiratory stridor in infants. It results from dynamic supraglottic collapse during inspiration, attributed to structural immaturity and hypotonia of the laryngeal cartilages, particularly the epiglottis and arytenoids.

Objective
To provide an overview of the clinical features, natural history, and management strategies of laryngomalacia in infants.

Methods
A narrative review of current literature and clinical practice guidelines was conducted, focusing on diagnosis, severity classification, and therapeutic interventions for laryngomalacia.

Results
Most cases are mild and resolve spontaneously by 18 to 24 months of age. However, approximately 10% are present with severe disease requiring surgical intervention. Indications for surgery include significant airway obstruction, feeding di Qualities, failure to thrive, or hypoxemia. Supraglottoplasty remains the treatment of choice in severe cases and has demonstrated high success rates with low morbidity. Tracheostomy is rarely indicated and

is generally reserved for cases unresponsive to supraglottoplasty or those with multiple comorbid conditions.

Conclusion
Laryngomalacia is a self-limiting condition in most infants, but a subset requires timely surgical intervention to prevent complications. Early recognition and appropriate referral are essential to optimize outcomes in severe cases