Laryngomalacia and OSAS in Young Children: A Case Series

During childhood, the Obstructive Sleep Apnea Syndrome (OSAS) represent a very common disease with a prevalence that range from 1% to 4%.Laryngomalacia is considered an uncommon cause of OSAS even though it can play a significant role in younger children especially during the first year of life.Congenital laryngomalacia is a common cause of stridor among infants, it is defined as collapse of supraglottic structures during inspiration and in more serious cases it may results in failure to thrive, feeding difficult, aspiration and obstructive disease during sleep.Both the "drug induced sleep endoscopy" (DISE) and flexible fiberoptic laryngoscopy are useful tools to identify respectively the level of upper airway obstruction and the severity and type of laryngomalacia.We present a brief case series comprising 5 children with laryngomalacia where we found a high prevalence of OSAS.All children underwent a sleep study (nocturnal Polysomnography or nocturnal pulse oximetry) and subsequently a fiberoptic laryngoscopy.All showed OSAS associated with laryngomalacia, and they were treated with CPAP therapy with objective improvement of apneas/desaturations number as documented by polysomnographic or pulse oximeter monitoring.