In visual assessment, which finding is associated with laryngomalacia?

• A. Collapse of the Laryngeal Cartilages on Inspiration
• B. Collapse of the Laryngeal Cartilages on Expiration
• C. Fixed Subglottic Stenosis
• D. Absence of Epiglottis

Answer: (A)

The key idea is that laryngomalacia shows a dynamic, inspiratory collapse of the supraglottic laryngeal structures when you visualize the airway. In infants with this condition, the floppy tissues above the vocal cords—especially the epiglottis and aryepiglottic folds—collapse inward as they inhale, causing the airway to narrow during inspiration. This inward motion is why inspiratory stridor is the hallmark finding on visual assessment, and you’ll often see the epiglottis retroflex or the inlet take on an omega shape during the inspiratory phase on flexible laryngoscopy.

This pattern distinguishes it from other possibilities. Collapse on expiration would not fit the classic laryngomalacia picture, since the problem is the inspiratory collapse of the supraglottic region rather than a expiratory event. A fixed subglottic stenosis presents as a constant, nondynamic narrowing at the subglottic level, not a tissue collapse of the supraglottic area during breathing. Absence of the epiglottis is a different congenital anomaly that would produce a markedly different airway appearance and dynamics, not the characteristic inspiratory collapse seen with laryngomalacia.