ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2022
Postoperative speech impairment and cranial nerve deficits after secondary surgery of posterior fossa tumours in childhood: a prospective European multicentre study.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 6 citations in OpenAlex.
- Predicting late-onset hydrocephalus in pediatric medulloblastoma: from static anatomy to dynamic biological assessment.Neurosurgical review · 2026Article
- Postoperative speech impairment and cranial nerve deficits in children undergoing posterior fossa tumor surgery with intraoperative MRI - a prospective multinational study.Acta neurochirurgica · 2025Observational
- Tumour volume as a predictor of postoperative speech impairment in children undergoing resection of posterior fossa tumours: a prospective, multicentre study.Acta neurochirurgica · 2025Article
- Proceedings of the first global meeting of the Posterior Fossa Society: state of the art in cerebellar mutism syndrome.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- PEG hydrogel sealant versus fibrin glue in posterior fossa surgery: an economic comparison across five European countries.Journal of comparative effectiveness research · 2024Article
- The Cerebellar Mutism Syndrome: Risk Assessment, Prevention and Treatment.Advances and technical standards in neurosurgery · 2023Article
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24 authors at 14 institutions in 9 countries.
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Abstract
purposeBrain tumours constitute 25% of childhood neoplasms, and half of them are in the posterior fossa. Surgery is a fundamental component of therapy, because gross total resection is associated with a higher progression-free survival. Patients with residual tumour, progression of residual tumour or disease recurrence commonly require secondary surgery. We prospectively investigated the risk of postoperative speech impairment (POSI) and cranial nerve dysfunction (CND) following primary and secondary resection for posterior cranial fossa tumours.
methodsIn the Nordic-European study of the cerebellar mutism syndrome, we prospectively included children undergoing posterior fossa tumour resection or open biopsy in one of the 26 participating European centres. Neurological status was assessed preoperatively, and surgical details were noted post-operatively. Patients were followed up 2 weeks, 2 months and 1 year postoperatively. Here, we analyse the risk of postoperative speech impairment (POSI), defined as either mutism or reduced speech, and cranial nerve dysfunction (CND) following secondary, as compared to primary, surgery.
resultsWe analysed 426 children undergoing primary and 78 undergoing secondary surgery between 2014 and 2020. The incidence of POSI was significantly lower after secondary (12%) compared with primary (28%, p = 0.0084) surgery. In a multivariate analysis adjusting for tumour histology, the odds ratio for developing POSI after secondary surgery was 0.23, compared with primary surgery (95% confidence interval: 0.08-0.65, p = 0.006). The frequency of postoperative CND did not differ significantly after primary vs. secondary surgery (p = 0.21).
conclusionChildren have a lower risk of POSI after secondary than after primary surgery for posterior fossa tumours but remain at significant risk of both POSI and CND. The present findings should be taken in account when weighing risks and benefits of secondary surgery for posterior fossa tumours.
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