What is Laryngomalacia

Laryngomalacia is a medical condition involving the epiglottis area of the airway.  It is a broad term used to describe a "floppy airway" from cartilage being too loose or tissue over the cartilage becoming large and inflamed from reflux.  It is a common, self-limiting disease with levels of severity.  Because the cartilage is loose, each breath of air can collapse the airway.  It is best to describe with a picture.

There are two tubes that lead from the mouth.  These two tubes are the Trachea and the esophagus's.  They connect below the back of your throat.  The trachea is the tube that is in front, you can feel it in front of your neck as the hard round tube.  This leads to your lungs and carries air from your nose and mouth to your lungs.  The esophagus is directly behind the trachea.  It is made of soft tissue and allows food to pass from your mouth to your stomach.  Because both are connected at the top, behind and below your throat, it could be easy for food to slip into your trachea if it were not for the epiglottis. 

The Epiglottis is one section of cartilage that makes up the area called the larynx.  The larynx is a  combination of different cartilage that and muscles.  It is the top of your trachea. The epiglottis is the largest of the cartilages; I like to think of it as the cap to your trachea, just like a cap to a milk jug.  The epiglottis is open always to allow air to flow into your lungs, easily and without any blockage.  After all, we need oxygen to live.  However, when it is time for food to go into our stomach for nutrition, we do not want even a minute amount of food or liquid to enter our lungs.  If it did, we could choke or get life threatening infections.  Without proper oxygenation, we would be very sick and death could occur.  Therefore, when we swallow, whether is food or our own saliva, the cartilage and muscle in the larynx pull on the epiglottis and closes it  tightly around the opening of the trachea. 

Now knowing the life or death importance of the larynx, you can understand how frightening it can be when it doesn't work properly.  In laryngomalacia, the cartilage that helps pull the epiglottis closed is too large or floppy.   Each breath causes the cartilage to lose shape and fall into the airway, making it difficult to take in full, deep breaths.  When it comes to eating, laryngomalacia can prevent the epiglottis from closing completely over the trachea, allowing small amounts of food to slip into it. 

That being said, many infants have the high pitched stridor from tissue flopping into the airway, but no complications.  Loud noisy breathing can be just that, loud and noisy.  Unfortunately, others may struggle to get enough oxygen in without great effort.  Most of the time infants with Layringomalacia do not have a lung problem so they can oxygenate fine.  It is the effort associated with getting oxygen into the lungs that cause the issues.

For more information follow the links below.

Children's Hospital of Philadelphia
http://www.chop.edu/service/airway-disorders/conditions-we-treat/laryngomalacia.html

Children's Memorial Hospital
http://www.childrensmemorial.org/depts/otolaryngology/nosethroat5.aspx

Lucile Packard Children's Hospital of Standford
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/respire/conlaryn.html