title: Dysphagia following posterior fossa surgery in adults.
abstract: OBJECTIVE
  Our study seeks to assess the incidence of aspiration and prolonged dysphagia needing enteral feeding at discharge (EFD) in adults after posterior fossa (p-fossa) surgery.
  
  
  METHODS
  A retrospective review was done on 56 patients with p-fossa surgery who needed a swallowing evaluation postoperatively. Questionnaires were sent to patients with EFD. Using univariate and multiple logistic regression analysis, risk factors for aspiration, EFD, and continued enteral feeds were identified.
  
  
  RESULTS
  Most patients were male and had p-fossa tumors. Multiple swallowing evaluations were needed in 25 (45%) patients. Aspiration was seen in 23 (41%) and 16 (27%) had EFD. Older age and number of evaluations were significantly associated with both aspiration and EFD (P < 0.05). Lateral approach was significantly associated with EFD (P = 0.047). In addition, multiple logistic regression identified aspiration as an independent significant predictor for EFD (P < 0.01). Mean operative time and tumor location did not have a significant correlation with EFD. At mean follow-up (15 months), only 5/16 needed continued enteral feeds.
  
  
  CONCLUSIONS
  Although 27% patients had EFD after p-fossa surgery, only 5/56 (9%) required continued enteral feeding. Aspiration, age, and lateral surgical approach is associated with EFD. In patients who demonstrate aspiration, we recommend placement of enteral feeding tube. Although most will not require continued enteral feeding at follow-up, longer follow-ups are needed.
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA.
authors: Rishi
authors: R
authors: Wadhwa
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA.
authors: Jamie
authors: J
authors: Toms
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA.
authors: Prashant
authors: P
authors: Chittiboina
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA.
authors: Tamir
authors: T
authors: Tawfik
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA.
authors: Chad
authors: C
authors: Glenn
authors: Department of Biometry, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA.
authors: Gloria
authors: G
authors: Caldito
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA.
authors: Bharat
authors: B
authors: Guthikonda
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Shreveport, Louisiana, USA. Electronic address: rwadhw1@lsuhsc.edu.
authors: Anil
authors: A
authors: Nanda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003388:Cranial Fossa, Posterior / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D003679:Deglutition; D003680:Deglutition Disorders / Q000178:diet therapy / Q000209:etiology*; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015192:Infratentorial Neoplasms / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D055815:Young Adult
keywords: Aspiration; Dysphagia; Enteral tube; Posterior fossa