Larynx as visualized from the hypopharynx.
The cartilages and ligaments of the larynx seen posteriorly.
External views of the larynx: (a) anterior aspect; (b) anterolateral aspect with the thyroid gland and cricothyroid ligament removed.
Sagittal section through the head and neck showing the subdivisions of the pharynx.
  • An uncontrolled or involuntary muscular contraction of the vocal folds.
  • Reflex is normally triggered when the vocal cords or the area of the trachea below the vocal folds detects the entry of water, mucus, blood, or other substance.
  • Associated with ketamine (0.3%)
    • Usually associated with large doses or rapid IV push


Clinical Features

  • Apnea may be the only sign in complete closure
  • Partial closure can manifest as stridor, guttural noises, and paradoxical chest movement

Differential Diagnosis

  • Oversedation
  • Failure of respiratory drive



  • Typically not indicated


  • Typically a clinical diagnosis


Apply pressure inwardly and anteriorly to the point labeled "Pressure Point" (Larson's Point) while applying a jaw thrust to relieve laryngospasm [1]
  • Jaw thrust
  • Place pressure on Larson's notch
  • If jaw thrust and pressure are not sufficient, bag valve mask with PEEP
  • If above do not resolve laryngospasm, sedate more deeply (propofol is the traditional choice, 0.5mg/kg)
  • If deeper sedation does not resolve laryngospasm, paralyze and intubate
  • In pediatric patients, consider gentle chest compressions


  • Observation for 2-3 hours after resolution for development of post-obstructive pulmonary edema, bradycardia (consider atropine), or aspiration

See Also

Airway Pages

External Links


  1. Larson CP Jr. Laryngospasm--the best treatment. Anesthesiology. 1998 Nov;89(5):1293-4. doi: 10.1097/00000542-199811000-00056. PMID: 9822036.