Stridor in the neonate: laryngomalacia.

Stridor in the neonate is usually congenital in etiology, the most common cause being laryngomalacia. Emergency airway management is always the first priority. The history is highly suggestive of the diagnosis in the majority of cases, but endoscopy is required for confirmation. The possibility of synchronous lesions must not be overlooked. Laryngomalacia presents with stridor usually within the first few weeks of life. The stridor is inspiratory in nature and varies with position and activity level. Anatomic, histologic, and neurologic factors have been proposed as the cause of laryngomalacia. Patients typically have a benign form of the disease, which they outgrow by age two. A small percentage of patients will have a severe form of the disease requiring surgical intervention.