{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:08:38Z","timestamp":1787764118678,"version":"build-2784847793"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Vocal fold motion impairment (VFMI) is a known consequence after high\u2010risk cardiac surgery. We implemented a universal laryngeal ultrasound (LUS) screening protocol for VFMI after the Norwood and aortic arch surgery. We hypothesized that LUS would accurately identify VFMI and predict postoperative aspiration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We implemented a screening algorithm with LUS for patients undergoing high\u2010risk cardiac surgery at a tertiary care pediatric hospital. Positively screened patients underwent flexible nasolaryngoscopy (FNL). Patients with an abnormal FNL underwent a video\u2010fluoroscopic swallow study (VFSS). Patient demographics, length of stay, and swallowing outcomes were assessed. Two\u2010tailed chi square and Wilcoxon rank sum tests were used to assess for differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010seven patients underwent either Norwood or arch reconstruction over a 16\u2010month period and underwent universal LUS. The average birth weight was 3.24\u2009kg (SD 0.57). Of the 67 patients, VFMI was identified by LUS and 100% confirmed on FNL in 58.21% (<jats:italic>n<\/jats:italic>\u2009=\u200939\/67) of patients. Aspiration and penetration on VFSS were higher in the group with VFMI as compared with those without VFMI (53.8% vs. 21.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.008). There was no difference in length of stay between patients who did not have a diagnosis of VFMI and those found to have VFMI (41.0\u2009days vs 45.3\u2009days <jats:italic>p<\/jats:italic>\u2009=\u20090.73).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Universal LUS screening for patients following high\u2010risk cardiac surgery may lead to earlier identification of postoperative VFMI and aspiration. Recognition of VFMI through this universal screening program could lead to earlier interventions and possibly improved swallowing outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:1939\u20131944, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31000","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T12:09:30Z","timestamp":1692878970000},"page":"1939-1944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ultrasound Screening After Cardiac Surgery Shows Vocal Fold Impairment and Predicts Aspiration"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7140-6671","authenticated-orcid":false,"given":"Jennifer M.","family":"Siu","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Colyer","sequence":"additional","affiliation":[{"name":"Division of Cardiology Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassie","family":"Horner","sequence":"additional","affiliation":[{"name":"Division of Cardiology Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Bhat","sequence":"additional","affiliation":[{"name":"Division of Cardiology Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyubomyr","family":"Bohuta","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titus","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2728-3576","authenticated-orcid":false,"given":"John P.","family":"Dahl","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Fridgen","sequence":"additional","affiliation":[{"name":"Division of Physical Therapy Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaalan","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Yip","sequence":"additional","affiliation":[{"name":"Division of Cardiology Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay R.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head &amp; Neck Surgery Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"359","article-title":"Vocal cord paralysis after cardiovascular surgery in children: incidence, risk factors and diagnostic options","volume":"57","author":"Garc\u0131a\u2010Torres E","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.02.014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3939"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.12.133"},{"issue":"234","key":"e_1_2_7_6_1","first-page":"2","article-title":"Long term outcomes of complete vascular ring division in children: a 36\u2010year experience from a single institution","volume":"24","author":"Naimo PS","year":"2017","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819858594"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26051"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949710600304"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2022.06.003"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.05.130"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009595"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.03.071"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.03.080"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.04.009"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.12.012"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2021.02.087"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29817"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818813002"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T13:00:26Z","timestamp":1719925226000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,24]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/lary.31000"],"URL":"https:\/\/doi.org\/10.1002\/lary.31000","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,24]]},"assertion":[{"value":"2023-03-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}