What is the common pathophysiology behind laryngomalacia?

Laryngomalacia is characterized primarily by the increased laxity of the supraglottic structures, which leads to an abnormal collapse of these tissues during respiration. This condition is the most common cause of stridor in infants and is typically diagnosed due to the inspiratory stridor that occurs, particularly noted when the child is in a supine position.

The increased laxity in the supraglottic area—comprising the epiglottis and surrounding soft tissues—results in a floppy airway that collapses during inhalation. When the structures are more pliable than normal, they can obstruct the airway, causing the characteristic stridor. In most cases, infants with laryngomalacia will improve as they grow and the structures become firmer with age.

Understanding this pathophysiology is crucial for managing patients with laryngomalacia, as it helps differentiate the condition from other airway issues that may involve strictures, mass effects, or muscular problems. This clarity allows healthcare providers to provide appropriate reassurance to parents and caregivers about the generally benign course of laryngomalacia.