A 6-week-old infant presents with inspiratory stridor that worsens when supine and improves when prone. The infant feeds well, has normal oxygen saturation, and appropriate weight gain. Flexible laryngoscopy shows inward collapse of the arytenoid cartilages during inspiration. What is the most appropriate management?
- A Immediate supraglottoplasty
- B Systemic corticosteroids
- C Observation with prone positioning ✓
- D Continuous positive airway pressure
Correct answer: C. Observation with prone positioning
Explanation
Laryngomalacia is the most common cause of infantile stridor and is typically mild and self-limiting, resolving by 12 to 18 months. Management is conservative with prone positioning and observation. Supraglottoplasty is reserved for severe cases with failure to thrive, apnea, or cor pulmonale. Corticosteroids and CPAP are not indicated in mild cases.
Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.