It is also called congenital laryngeal stridor. It is abnormal soft falccid larynx that collapses during inspiration resulting in stridor and sometimes feeding difficulty and obstructive sleep apnea. Examination by flexible laryngoscope will reveal:
Treatment: It is self limiting disease and just need reassurance with Calcium and vitamin D supplementation.
Congenital laryngeal web
It is a fibrous band connects the anterior 1/3 or 2/3 of the vocal cords due to arrest of canalization at the 10th week of gestation. Clinical picture: 1-Small web is asymptomatic while large web presents with hoarseness and stridor. 2-Imporforate type presents with cyanosis and still birth.
Examination by flexible laryngospe will reveal the web.
Treatment involves tracheostomy in cases of severe stridor or direct laryngoscopy (DL) under general anesthesia with excision of the we using laser.
Congenital subglottic stenosis
It is stenosis at the level of the cricoid cartilage in the subglottic area. The patient usually presents with biphasic stridor since birth without a hoarse cry. Endoscopic examination will reveal the condition:
Treatment is by endoscopic dilatation or laser ablation or it might need cricoid split or even tracheal resection and anastomosis.
It appears at the first year of life then spontaneously involutes by age. It may be associated with cutaneous hemangiomas. It presents with biphasic stridor at 3-6 months age that increases on crying without hoarseness. Endoscopic examination will revel a subglottic reddish mass.
Treatment is conservatively as it will regress by age. It may be removed by endoscopic laser ablation.
Congenital laryngeal cysts
It may be saccular or ductal. It may be located in the ventricular bands, ary-epiglottic folds and tongue base. It may present with stridor without hoarseness. Examination will reveal smooth globular mass at the previous sites.
Treatment is by endoscopic evacuation and marsupiulization (deroofing).
Laryngo-esophageal cleft may present with aspiration, hoarseness and stridor.