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Current time:0:00Total duration:4:51

Video transcript

laryngomalacia is a congenital disorder meaning it's a birth defect of the larynx now Malaysia means softness so translate directly this means softness of the larynx and technically you can think that's what's going on here now over here I have a normal side view of what the larynx looks like and over here I have a top view of the normal larynx so in both these views you can see the epiglottis right here the piece of soft tissue that folds down protecting the airway when you swallow further down is the re epiglottis folds so really these go all the way down to where the larynx is close to the voice box and they're named the re or aryepiglottic folds because they're soft tissue that really is in between the epiglottis and the original cartilage now the written oeid cartilage is around here and it's buried in the soft tissue and it's really what the vocal cords are connected to now patients with Lou Ringo Malaysia or laryngomalacia have an airway that looks a little more like this live Ringo Malaysia is softness of the cartilage of not only the re epiglottis olds in the epiglottis but more particularly the cartilage around the voice box around the larynx the issue is that since this cartilage is so soft it leads to collapsing of the airway so above the opening of the vocal cords which is also known as the glottic opening so above the glottic opening this soft tissue can collapse and obstruct the airway now since it's congenital or again in other words a birth defect it's noted in young children around four to eight months old can be noted earlier and it can be noted later before two eight months is when it's most severe so you can see because this tissue is so weak when a patient tries to pull air into their lungs through the glottic opening it snaps shut because of all the pressure around so the physiology is when you inhale air you creating a negative pressure the lungs and that allows air to be pulled into the lungs but that negative pressure acts like a vacuum and sucks this soft tissue this softness Malaysia laryngomalacia it sucks this closed so patients have a difficulty breathing and this leads to signs of low oxygen such as cyanosis which is when the skin turns blue another common symptom is Strider and Striders a musical noise on inspiration because the airway is so narrow when air rushes past the glottic opening it makes a noise a musical noise Strider is very similar to air rushing through a window if a window is partially open and air rushes in it'll make a howling noise right you've heard of howling wind before and so it's a similar concept that produces stride or patients with laryngomalacia also experienced gastro esophageal reflux reflux from the stomach this can be an issue because not only can the acid get into the lungs and cause damage but can also further cause damage to the larynx and the surrounding soft tissue which further narrows the airway so reflux can be a potential complication in these patients and along with difficulty breathing and reflux a patient may have a difficult time feeding as well because when they eat it makes it more difficult to breathe air in so patients may experience difficulty feeding leading to poor weight gain and even weight loss now diagnosis of laryngomalacia has to do with directly observing the airway tissue in fact I've drawn the epiglottis curved like this because this is actually a very typical sign of laryngeal Malaysia it's called an Omega sign because the soft tissue curves in a way that looks like the Greek letter Omega so Omega sign along with these symptoms leads to the diagnosis of lingo Malaysia now treatment of this disorder is actually very limited but thankfully most of the time treatment is not needed if the symptoms are mild for example if the patient only experiences mild difficulty breathing when feeding then reassurance and follow-up with the patient maybe the best solution in fact resolution of laryngomalacia is usually around 18 to 20 months however if symptoms are very severe then surgery should be pursued and the surgery involves cutting down the re epiglottis folds to open the airway up a little bit more