A 4-month-old infant presents with inspiratory stridor since birth that worsens when supine and improves in the prone position. Feeding is mildly affected but weight gain is normal. Flexible laryngoscopy shows omega-shaped epiglottis and shortened aryepiglottic folds. What is the most likely diagnosis?
- A Vocal cord paralysis
- B Subglottic stenosis
- C Laryngomalacia ✓
- D Tracheomalacia
Correct answer: C. Laryngomalacia
Explanation
Laryngomalacia is the most common cause of stridor in infants. The classic presentation includes inspiratory stridor that worsens supine and improves prone, with findings of omega-shaped epiglottis and shortened aryepiglottic folds on laryngoscopy. Most cases are mild and resolve spontaneously by 12-18 months without surgical intervention.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.