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Congenital laryngomalacia is related to exercise-induced laryngeal obstruction in adolescence
  1. Magnus Hilland1,
  2. Ola Drange Røksund1,2,
  3. Lorentz Sandvik1,
  4. Øystein Haaland2,3,
  5. Hans Jørgen Aarstad1,4,
  6. Thomas Halvorsen2,5,
  7. John-Helge Heimdal1,4
  1. 1Department of Otolaryngology & Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
  2. 2Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
  3. 3Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  4. 4Department of Clinical Medicine, University of Bergen, Bergen, Norway
  5. 5Department of Clinical Science, Section for Pediatrics, University Bergen, Bergen, Norway
  1. Correspondence to Magnus Hilland, Department of Otolaryngology & Head and Neck Surgery, Haukeland University Hospital, Haukelandsveien 22, Bergen 5021, Norway; magnus.hilland{at}


Objectives Congenital laryngomalacia (CLM) is the major cause of stridor in infants. Most cases are expected to resolve before 2 years of age, but long-term respiratory prospects are poorly described. We aimed to investigate if CLM was associated with altered laryngeal structure or function in later life.

Methods Twenty of 23 (87%) infants hospitalised at Haukeland University Hospital during 1990–2000 for CLM without comorbidities and matched controls were assessed at mean age 13 years. Past and current respiratory morbidity was recorded in a questionnaire, and spirometry performed according to standard quality criteria. Laryngoscopy was performed at rest and continuously throughout a maximal treadmill exercise test (continuous laryngoscopy exercise test (CLE-test)), and scored and classified in a blinded fashion according to preset criteria.

Results In the CLM group, laryngeal anatomy supporting CLM in infancy was described at rest in nine (45%) adolescents. Eleven (55%) reported breathing difficulties in relation to exercise, of whom 7 had similarities to CLM at rest and 10 had supraglottic obstruction during CLE-test. Overall, 6/20 had symptoms during exercise and similarities to CLM at rest and obstruction during CLE-test. In the control group, one adolescent reported breathing difficulty during exercise and two had laryngeal obstruction during CLE-test. The two groups differed significantly from each other regarding laryngoscopy scores, obtained at rest and during exercise (p=0.001 or less).

Conclusions CLM had left footprints that increased the risk of later exercise-induced symptoms and laryngeal obstruction. The findings underline the heterogeneity of childhood respiratory disease and the importance of considering early life factors.

  • Exercise induced inspiratory symptoms
  • Congenital laryngomalacia
  • Vocal cord dysfunction
  • Respiratory Disorders
  • Follow-up study

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