The Prevalence and Risk Factors of Dysphagia Among Infants Diagnosed With Laryngomalacia

Objective Laryngomalacia is the most common cause for stridor in infants. Despite most resolving by itself, laryngomalacia could have a serious impact on feeding and breathing, and thus affect growth. Data about the prevalence of dysphagia, associated contributing factors to dysphagia, and outcome were lacking. Method This is a two‐center retrospective observational study of patients with endoscopically diagnosed laryngomalacia from January 1, 2010 to December 31, 2021. The prevalence of dysphagia in 18 months, which was diagnosed by allied health professionals, in this group was reviewed. The relationship of dysphagia with associated contributing factors, including gastroesophageal reflux disease (GERD), congenital heart disease, neurological diseases, genetic syndromes, and concomitant airway lesions, was studied. The growth parameters in different groups were compared. Result Fifty‐five patients with endoscopically diagnosed laryngomalacia were identified. Thirty‐nine (70.9%, 95% CI: 57.9%–81.2%) of them had dysphagia. Within this group, 17 patients (43.6%) required ventilatory support. The cohort was further divided to dysphagia and nondysphagia group for further analysis of associated contributing factors. Those with GERD were 7.26 times more likely to develop dysphagia ( p = 0.011). This cohort demonstrated growth failure (SD = −1.46 to −2.57) at diagnosis compared with local growth reference. Catch‐up growth was significant when they had partial or full feeding support, by either nasogastric tube or gastrostomy. Conclusion This study showed that the prevalence of dysphagia is high in endoscopically proven laryngomalacia. Coexistence of GERD is significantly associated with the presence of dysphagia and hence intensive antireflux management is recommended. Besides, a significant portion of patients had growth and respiratory compromises needing different kinds of support. Early feeding intervention is recommended as it was proven to help with catch‐up growth.