Congenital Laryngomalacian

Congenital Laryngomalacia is the most common cause of breathing noise (stridor) in children and newborns (Kiran, Rajesh & Baliga, 2015). This is the most frequent congenital voice box malformation in babies (larynx). Congenital Laryngomalacia is defined as floppy tissue above the voice cords that falls into an infant’s airway during breathing.

The information provided appears to be atypical for the infant. Further testing should be performed to determine the source of the problem.

The patient’s history was unavailable. The parents were not present to present the infant’s medical history. The doctor performed a flexible laryngoscopy with the help of a caregiver on the infant. The infant was held by the caregiver in a semi reclined position. A flexible laryngoscope passed through the nose showed an abnormal movement of the laryngeal structures during spontaneous respiration.

Impedance probe: The infant showed a high incidence of gastroesophaegeal reflux with severe laryngomalacia.

Flexible laryngoscopy: The diagnosis revealed that the vocal cords of the infant are floppy.

Neck and chest X-rays: X-ray conducted showed that the infant does not have any other problems in the upper airway.

Airway fluoroscopy: This diagnosis was carried out to determine the specificity and sensitivity of the airway fluoroscopy. It showed there was a partial of the partial airway.

Intervention

The intervention for the children is prescription of anti-reflux medication. This prescription helps to manage the gestroesophageal reflux (GERD). The chronic chest and neck retractions from the larngomalacia could worsen the reflux. Conversely, the acid reflux can worsen noisy breathing through the swelling of the vocal cords. The infant shows severe congenital laryngomalacia. Suproglottoplasty surgery should be carried out as an alternative treatment (Escher, Probst & Gysin, 2015). The surgery may not eliminate noisy breathing but will improve swallowing, help child gain weight, lessen apneas and reduce severity of symptoms.

Evaluation

The patient met expected outcomes by showing a high incidence of gastroesophaegeal reflux. The infant also met expectations by having floppy vocal cords. This showed that the baby had congenital laryngomalacia. The recommended procedure is Suproglottoplasty surgery to correct the condition.

References

Escher, A., Probst, R., & Gysin, C. (2015). Management of laryngomalacia in children with congenital syndrome: the role of supraglottoplasty. Journal of pediatric surgery, no. 50, pp. 519-523.

Kiran, B., Rajesh, S. M., & Baliga, B. S. (2015). Laryngomalacia in Neonates: A Review and the Surgical Management or Severe Cases. J Neonatal Biol, no. 4, pp. 42167-0987.