1. What is the most likely diagnosis?
This infant is most likely to have a diagnosis of laryngomalacia.
Laryngomalacia is the commonest congenital laryngeal abnormality and a relatively common cause of stridor in infancy. An abnormality of the laryngeal cartilages causes the larynx to be soft and floppy and collapse during inhalation causing partial airway obstruction.
Presentation tends to occur within a few weeks of birth with inspiratory stridor that is worse when feeding, agitated or lying in the supine position. The stridor is often described as being ‘high-pitched’ or ‘crowing’. The stridor can be worsened by co-existing coryza and tends to initially worsen before spontaneously resolving within the first 18-24 months of life.
2. Which investigation can confirm this diagnosis?
3. What advice would you give the parents in this case?
The parents should have the diagnosis explained and be reassured that it is a benign disorder that usually settles without treatment. A referral to ENT should be made so that the diagnosis can be confirmed.
Header image used on licence from Shutterstock