Inclusion Criteria:  Only patients with parents/ carers able to give informed consent to participation in the trial will be included. • Male and female patients will be included Only Neonates (babies less than 28 days of age) will be included in the study. Only patients undergoing repair of the aortic arch via median sternotomy will be included in the study  Exclusion Criteria:  Patients with severe abnormalities of the airway, such that they are unlikely to be extubated within 7 days of the aortic arch repair surgery will be excluded from participation, as assessment of vocal cord function will be difficult/ impossible in such patients. Patients with parents/ carers who are unable to give informed consent to participation in the trial will be excluded from participation.