Pre and post-surgical dysphagia outcome associated with posterior fossa tumour in children.

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.