Laryngomalacia (Adult)

Laryngomalacia is a condition where the soft tissue structures at the top of the voice box are unusually floppy, causing them to partially collapse and narrow the airway during breathing. While it's typically thought of as a condition affecting infants, adults can develop similar symptoms, sometimes following a viral illness.

It's thought that viral infections affecting the throat can trigger temporary weakness or altered function of the tissues supporting the airway, leading to noisy or laboured breathing that persists after the initial infection resolves. The exact mechanism isn't fully understood in adult-onset cases.

Symptoms include noisy breathing, particularly a harsh sound on breathing in (inspiratory stridor), which may worsen with exertion, lying flat, or during upper respiratory infections. Some people also notice voice changes or a sensation of breathlessness.

In most adult cases symptoms are bothersome rather than dangerous, but significant airway narrowing can occasionally cause real breathing difficulty needing assessment. An ENT evaluation helps determine severity and whether treatment is needed.

In infants there may be a mild genetic or developmental component, but adult post-viral cases are thought to relate to the after-effects of infection rather than heredity. It's not typically passed on within families in a predictable pattern.

Many mild cases improve gradually over weeks to months as any post-viral inflammation settles, without needing specific treatment. Persistent or worsening symptoms warrant further ENT assessment to check for any structural issue needing treatment.

Treatment depends on severity, ranging from watchful monitoring for mild cases, to voice and breathing therapy, and in more significant or persistent cases, surgical procedures to stiffen the affected tissue. Your ENT specialist will tailor treatment to your specific findings.

Diagnosis typically involves a nasendoscopy, where a thin flexible camera is passed to directly visualise the airway during breathing, often specifically assessing for the characteristic collapse pattern. This can usually be done comfortably in an outpatient clinic setting.

Laryngomalacia involves structural floppiness of tissue above the vocal cords causing airway narrowing, while vocal cord dysfunction involves the vocal cords themselves inappropriately closing during breathing, often triggered by exercise or anxiety. Direct visualisation with a scope during symptoms helps distinguish between the two.

Persistent noisy or laboured breathing, especially if worsening, should be assessed by an ENT specialist. Private ENT consultations can typically be arranged within about two weeks, considerably faster than standard NHS waiting times.