Abstract
Background Swallowing impairment (dysphagia) has been reported as a possible sequela following surgical removal of posterior fossa tumours (PFT). Dysphagia may result in aspiration of food/fluid leading to respiratory tract infection, placing the patient at considerable health risk. No prospective studies have investigated dysphagia pre and post-surgical removal of PFT. The present study aimed to document the presence, severity and characteristics of dysphagia pre and post-surgical resection of PFT, and to determine whether children were managing a normal oral diet (i.e. a measure of functional swallowing ability) at two months post-surgery. Methods Dysphagia was assessed using a clinical bedside evaluation in 11 participants (8 M; aged 3 years 6 months to 13 years 5 months) pre (within 3–5 days) and post-surgery (within 1–2 weeks). Return to normal oral feeding was documented at two months post-surgery via a parent telephone interview. Results and conclusion No participant had dysphagia pre-surgically. Seventy three percent (8/11) had dysphagia at 1–2 weeks post-surgery, primarily characterized by impaired lip closure (8/8), poor mastication (8/8), and inefficient oral transit (8/8). Whilst dysphagia severity was largely mild (6/8) in presentation, data suggest that assessment and monitoring of this disorder may be required in the acute phase post-surgery. Overall however, prognosis appeared positive, with 75% (6/8) of participants managing a full oral diet at 2 months post-surgery.
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Aarsen FK, Van Dongen HR, Paquier PF, Van Mourik M, Catsman-Berrevoets CE (2004) Long-term sequelae in children after cerebellar astrocytoma surgery. Neurology 62(8):1311–1316
Hanif G, Shafqat S (2004) Morphological pattern and frequency of intracranial tumours in children. J Coll Physicians Surg Pak 14(3):150–152
Ibrahim K, Appleton R (2004) Seizures as the presenting symptom of brain tumours in children. Seizure 13(2):108–112
Cornwell PL, Murdoch BE, Ward EC, Morgan AT (2003) Dysarthria and dysphagia as long-term sequelae in a child treated for posterior fossa tumour. Pediatr Rehabil 6(2):67–75
Cornwell PL, Murdoch BE, Ward EC, Morgan AT (2003) Dysarthria and dysphagia following treatment for a fourth ventricle choroid plexus papilloma. J Clin Neurosci 10(4):506–512
Newman LA, Boop FA, Sanford RA, Thompson JW, Temple CK, Duntsch CD (2006) Postoperative swallowing function after posterior fossa tumor resection in pediatric patients. Childs Nerv Syst 22(10):1296–1300
Pollack IF, Polinko P, Albright AL, Towbin R, Fitz C (1995) Mutism and pseudobulbar symptoms after resection of posterior fossa tumors in children: incidence and pathophysiology. Neurosurgery 37:885–893
Martin BJ, Corlew MM, Wood H, Olson D, Golopol LA, Wingo M, Kirmani N (1994) The association of swallowing dysfunction and aspiration pneumonia. Dysphagia 9(1):1–6
Reilly S, Skuse D, Poblete X (1996) Prevalence of feeding problems and oral motor dysfunction in children with cerebral palsy: a community survey. J Pediatr 129(6):877–882
Morgan AT, OMahney H, Francis H (2007) The use of pulse oximetry as a screening tool for paediatric neurogenic dysphagia. Dev Neurorehabil Oct 15:1–14 (https://mx1.mcri.edu.au/pubmed/17943501?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum)
Morgan AT, Ward EC, Murdoch BE (2004) Acute clinical characteristics of paediatric dysphagia following traumatic brain injury. J Head Trauma Rehabil 19(3):226–240
Morgan AT, Ward EC, Murdoch BE (2005) Resolution of paediatric dysphagia following traumatic brain injury: radiological assessment. Med J Speech-Language Pathol 13(2):109–125
Morgan AT, Ward E, Murdoch B, Kennedy B, Murison R (2003) Incidence, characteristics and predictive factors for dysphagia following paediatric traumatic brain injury. J Head Trauma Rehabil 18(3):239–251
Morgan AT, Ward EC, Murdoch BE (2004) Clinical progression and outcome of pediatric dysphagia following traumatic brain injury. Brain Inj 18(4):359–376
Huber J, Bradley K, Spiegler B, Dennis M (2007) Long-term neuromotor speech deficits in survivors of childhood posterior fossa tumors: effects of tumor type, radiation, age at diagnosis, and survival years. J Child Neurol 22(7):848–854
Catsman-Berrevoets CE, van Dongen HR, Mulder PGH et al (1999) Tumour type and size are high risk factors for the syndrome of ‘cerebellar’ mutism and subsequent dysarthria. J Neurol Neurosurg Psychiatry 67:755–757
Acknowledgements
Many thanks to Kim Phipps (Research Coordinator for Neurosurgery at Great Ormond Street Hospital for Children NHS Trust), for her assistance in recruitment, for obtaining medical data on each participant.
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Morgan, A.T., Sell, D., Ryan, M. et al. Pre and post-surgical dysphagia outcome associated with posterior fossa tumour in children. J Neurooncol 87, 347–354 (2008). https://doi.org/10.1007/s11060-008-9524-6
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DOI: https://doi.org/10.1007/s11060-008-9524-6