The goal of this prospective, observational study is to evaluate for the presence of vocal fold motion impairment (VFMI) in the children admitted to the pediatric intensive care unit on noninvasive positive pressure ventilation (NIV PPV). Participants will have two ultrasounds of their vocal folds performed, once while on NIV PPV and once after weaned off of the NIV PPV. This results of these scans will be reviewed against one another and against the gold standard, fiberoptic nasolaryngoscopy (FNL). The main question this study aims to answer is: Can POCUS be used to reliably detect VFMI while pediatric patients on supported with NIV PPV?
Age 0 to 18 years
Scheduled to receive a fiberoptic nasolaryngoscopy with the otolaryngology team to assess for vocal fold motion impairment
Status post great vessel, esophageal, or tracheal surgery that could disrupt the recurrent laryngeal nerve
Tracheostomy in place
Age >18 years
History of vocal cord paralysis/paresis
Patients who cannot have their neck placed in a neutral or slightly extended position due to injury or ligament laxity