{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:10:53Z","timestamp":1755216653337,"version":"3.43.0"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Paradoxical vocal cord motion (PVCM) in pediatric patients is a cause of stridor and respiratory distress wherein vocal cords adduct (close) with inhalation and, at times, adduct with exhalation, causing pronounced stridor and respiratory distress. Symptoms respond to specialized breathing exercises guided by a speech therapist with expertise in paradoxical vocal cord motion. Frequently, because of poor response to pharmaceutical therapies, children often experience overtreatment in attempts to curtail respiratory symptoms. PVCM can be difficult to distinguish from other etiologies (eg, asthma or croup) without flexible laryngoscopy or pulmonary function tests. However, laryngoscopy is invasive, and both require equipment and specialists not readily available in many pediatric emergency departments. Because of the episodic nature of PVCM, outpatient diagnostic testing can be inconclusive if an exacerbation has resolved by the time of testing. Visualization of the vocal cords at the time of presentation is key to the diagnosis and timely treatment of PVCM. Although there is pediatric literature reporting the utility of laryngeal Point-of-care Ultrasound (POCUS) to noninvasively visualize vocal cord paralysis, there is scant literature examining the utility of POCUS in the diagnosis and monitoring of PVCM. Here, we present 3 cases where we used laryngeal POCUS in the pediatric emergency department to capture PVCM with a video laryngoscopy correlation. Case Presentation<\/jats:p>","DOI":"10.1097\/pec.0000000000003370","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T07:00:26Z","timestamp":1748847626000},"page":"658-660","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic and Therapeutic Applications of Laryngeal Point-of-care Ultrasound in Paradoxical Vocal Cord Movement"],"prefix":"10.1097","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7181-4077","authenticated-orcid":false,"given":"Anelah","family":"McGinness","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Tobey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh Medical Center Children\u2019s Hospital Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devora","family":"Bita Azhdam","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"R1-20250804","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1002\/lary.29582","article-title":"Learning to interpret pediatric vocal fold mobility: a laryngeal ultrasound training module","volume":"131","author":"Alexander","year":"2021","journal-title":"Laryngoscope"},{"key":"R2-20250804","doi-asserted-by":"crossref","first-page":"e532","DOI":"10.1097\/PCC.0000000000002734","article-title":"Assessment of vocal cord motion using laryngeal ultrasound in children: a systematic review and meta-analysis","volume":"22","author":"Hamilton","year":"2021","journal-title":"Pediatr Crit Care Med"},{"key":"R3-20250804","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1177\/0194599819877650","article-title":"Application-based translaryngeal ultrasound for the assessment of vocal fold mobility in children","volume":"161","author":"Sayyid","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R4-20250804","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.ijporl.2019.04.017","article-title":"The role of laryngeal ultrasound in the assessment of pediatric dysphonia and stridor","volume":"122","author":"Shirley","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"R5-20250804","doi-asserted-by":"crossref","first-page":"e120","DOI":"10.1097\/JSM.0000000000000641","article-title":"Can ultrasound identify paradoxical vocal fold movement? A pilot study","volume":"30","author":"Finnoff","year":"2020","journal-title":"Clin J Sport Med"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T16:00:23Z","timestamp":1754323223000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":5,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003370","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"type":"print","value":"0749-5161"},{"type":"electronic","value":"1535-1815"}],"subject":[],"published":{"date-parts":[[2025,6,2]]},"assertion":[{"value":"2024-10-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}