The differential diagnosis of upper airway obstruction in children includes infectious and noninfectious causes (Table). When evaluating a child with stridor, the clinician must know how to differentiate between various anatomical anomalies (laryngomalacia, tracheomalacia, and subglottic stenosis) and infectious conditions (croup, epiglottitis, and bacterial tracheitis) to promptly implement appropriate management.
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Laryngomalacia refers to the prolapse of supraglottic structures into the laryngeal airway on inspiration, which usually manifests as a primarily inspiratory stridor in young children.
Laryngomalacia is the most common congenital laryngeal anomaly and is the most frequent congenital cause of stridor in infants. Often symptoms are not present at birth, and affected children typically develop stridor in the first 2 weeks of life, with symptoms becoming most pronounced in the first 2 to 4 months. This condition is often self-limited and typically resolves between the ages of 12...