laryngomalacia

DEFINITION of laryngomalacia

laryngomalacia is the most common cause of chronic stridor in infants, resulting from the structural immaturity of the laryngeal cartilages. During inspiration, the epiglottis and/or arytenoid cartilages are pulled into the airway lumen due to negative intrathoracic pressure, creating a partial obstruction. While often self-limiting and resolving by 18–24 months, severe cases may require surgical intervention. It is distinct from subglottic stenosis (Q31.1) or vocal cord paralysis (J38.0), which present with different acoustic signatures. Clinical subtypes include anterior epiglottic collapse, arytenoid prolapse, and short aryepiglottic folds, each coded under Q31.5.

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ETYMOLOGY of laryngomalacia

greek

Component	Origin	Meaning
o-	Greek, larynx	”Voice box” — the primary organ of phonation and airway protection.
-malacia	Greek, malakia	”Softness” — referring to abnormal softening of tissues.
Suffix	Greek, -ia	Condition or state of being.

The term entered medical English in the late 19th century to describe the “softening of the larynx.” It combines the anatomical root for the voice box with the pathological suffix for tissue softening, mirroring terms like osteomalacia (softening of bone).

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🔀 ALIASES / ALTERNATE TERMS

• Laryngomalacic (adjectival descriptor for airway findings)
• Congenital laryngeal stridor (classic clinical presentation)
• Floppy larynx (descriptive lay term)
• Supraglottic collapse (anatomical classification)
• Primary laryngomalacia (idiopathic form)
• Secondary laryngomalacia (associated with G71.0 neuromuscular disease)
• Epiglottic prolapse (specific anatomical subtype)
• Arytenoid prolapse (specific anatomical subtype)
• Short aryepiglottic folds (anatomical subtype)
• Congenital laryngeal anomaly (broad category Q31.8)
• Infantile airway obstruction (clinical syndrome)
• Laryngeal chondromalacia (pathological descriptor)

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🔗 RELATED TERMS

• Laryngospasm — the opposite of Laryngomalacia; an acute, involuntary contraction of vocal cords rather than structural collapse.
• Tracheomalacia — shares the root; softening of the tracheal cartilages (Q32.0).
• Subglottic Stenosis — narrowing below the glottis, often acquired via intubation (Q31.1).
• Vocal Cord Paralysis — neurogenic cause of stridor (J38.0).
• Inspiratory Stridor — the hallmark physical sign of upper airway obstruction.
• Supraglottoplasty — the primary surgical correction for severe cases.
• Gastroesophageal Reflux — exacerbating factor often comorbid with Laryngomalacia (K21.9).
• Laryngitis — inflammation of the larynx (J04.0).
• Laryngocele — cystic dilation of the laryngeal ventricle (Q31.3).
• Laryngeal Cleft — congenital communication between larynx and esophagus (Q31.5).
• Flexible Laryngoscopy — the gold standard diagnostic procedure.

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CODING CORNER

🏥 ICD-10-CM CODES

Congenital Malformations of Larynx

Code	Description
Q31.5	Congenital laryngomalacia
Q31.8	Other congenital malformations of larynx
Q31.9	Congenital malformation of larynx, unspecified
Q32.0	Congenital tracheomalacia
R06.1	Stridor
J38.0	Paralysis of vocal cords and larynx
K21.9	Gastro-esophageal reflux disease without esophagitis
R06.81	Apnea, not elsewhere classified

Related Respiratory Symptoms

Code	Description
R06.00	Dyspnea, unspecified
R06.03	Acute respiratory distress
J98.8	Other specified respiratory disorders
P28.89	Other specified respiratory conditions of newborn

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🔧 COMMON CPT CODES (Laryngomalacia-Related Diagnosis & Treatment)

CPT Code	Description
31575	Laryngoscopy, flexible; diagnostic
31579	Laryngoscopy, flexible; with stroboscopy
31525	Laryngoscopy, direct; diagnostic
31545	Laryngoplasty, partial, with arytenoidectomy
31546	Laryngoplasty, partial, with supraglottoplasty
31572	Laryngoscopy, direct, with injection
31573	Laryngoscopy, direct, with therapeutic injection
31574	Laryngoscopy, direct, with injection of vocal cord
92511	Nasopharyngoscopy with endoscope
99213	Office visit, established patient
99203	Office visit, new patient

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⚠️ Coding Note: When coding for Q31.5, ensure the documentation specifies the severity and the presence of failure to thrive or apnea, as these may support higher-level E/M codes. supraglottoplasty (31546) is the definitive surgical procedure; ensure the operative report clearly describes the division of the aryepiglottic folds. If the patient has comorbid GERD, code K21.9 as a secondary diagnosis to justify medical management (e.g., PPI therapy).

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DERIVATIONS of laryngomalacia

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(roots, (word) => econtains([[laryngomalacia]].roots, word))) > 0 AND file.name != [[laryngomalacia]].file.name
SORT file.name ASC

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Query functionality

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(definition, (word) => econtains([[laryngomalacia]].definition, word))) > 0 AND file.name != [[laryngomalacia]].file.name

Med terms dictionary Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms