Impact of surgery and adjuvant therapy on balance function in children and adolescents with cerebellar tumors.
OBJECTIVE
This study examined the effects of posterior fossa tumor surgery and concomitant irradiation and/or chemotherapy on the long-term recovery of balance function in children and adolescent patients.


METHODS
22 patients, treated during childhood for a benign (n = 14) or malignant cerebellar tumor (n = 8), were examined in chronic state (mean latency between surgery and testing: 7.7 years, range 3 - 17 years). Postural impairments were assessed with static and dynamic posturography. All cerebellar lesions were documented by standardized and normalized MRI data. Healthy age- and gender-matched subjects served as a control group.


RESULTS
Comparing the balance function of (i) children with or without affected cerebellar nuclei and (ii) children with and without adjuvant chemotherapy and/or radiotherapy revealed that damage to the cerebellar nuclei had more impact on neurological impairment than concomitant tumor therapy. Balance abnormalities were most pronounced when a lesion affected the fastigial nucleus. Chemotherapy with its neurological side effect was associated with enhanced postural sway in only two children with malignant tumors.


CONCLUSIONS
The study results indicate that the sparing of the deep cerebellar nuclei had the greatest impact on the recovery of balance function in pediatric patients treated for both a benign or malignant cerebellar tumor.
Schoch
B
B
Department of Neurosurgery, University of Duisburg-Essen, Essen, Germany. beate.schoch@uni-essen.de
Konczak
J
J
Dimitrova
A
A
Gizewski
E R
ER
Wieland
R
R
Timmann
D
D
D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002529:Cerebellar Nuclei / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D002531:Cerebellum / Q000187:drug effects / Q000528:radiation effects / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination / Q000187:drug effects; D011183:Postoperative Complications / Q000175:diagnosis / Q000473:pathology; D004856:Postural Balance / Q000187:drug effects / Q000528:radiation effects; D018714:Radiotherapy, Adjuvant