title: One-year outcome of postoperative swallowing impairment in pediatric patients with posterior fossa brain tumor.
abstract: Impaired swallowing in children who underwent posterior fossa brain tumor (PFBT) resection disrupts development and quality of life, yet its downstream consequences remain unclear. This study explored the risk factors and functional prognosis of postoperative swallowing impairment in pediatric patients (<19 years old) with PFBT. Among 183 patients with PFBT who underwent surgical resection, 39 patients with postoperative swallowing difficulty were analyzed using the videofluoroscopic swallowing study (VFSS). The association between clinical features, swallowing characteristics, and swallowing impairment was explored during the early postoperative phase and 1-year following surgical resection. Duration of tube feeding was investigated using Kaplan-Meier analysis. Twenty-seven (14.8 %) patients needed tube feeding in the early postoperative phase and 11 (6.01 %) at 1-year after surgical resection. Mean duration of tube feeding was 240.2 days and differed by tumor pathologies (P = 0.001), delayed triggering of pharyngeal swallow (DTP) (P = 0.002) and pharyngeal wall coating (P = 0.033). Tumor pathology was associated significantly with the referral for swallowing evaluation (P < 0.001) and 1-year tube feeding (P = 0.019). Tube feeding at 1-year was significantly associated with the tumor's brainstem involvement (P = 0.039), and swallowing abnormalities at early phase including DTP (P = 0.030) and pharyngeal wall coating (P = 0.004). Our results suggest that tumor pathology, brainstem involvement, and specific swallowing abnormalities at early phase are important risk factors for sustained 1-year swallowing impairment following surgical resection. These results can be applied to determine the plan of evaluation, nutrition, and intervention in clinical practice.
authors.affiliation: Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.|Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Woo Hyung
authors.initials: WH
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. keepwiz@gmail.com.|Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. keepwiz@gmail.com.
authors.forename: Byung-Mo
authors.identifier: http://orcid.org/0000-0001-9353-7541
authors.initials: BM
authors.lastname: Oh
authors.affiliation: Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Han Gil
authors.initials: HG
authors.lastname: Seo
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Phi
authors.affiliation: Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sangjoon
authors.initials: S
authors.lastname: Chong
authors.affiliation: Department of Rehabilitation Medicine, Gangwon-Do Rehabilitation Hospital, Chuncheon, Republic of Korea.
authors.forename: Tai Ryoon
authors.initials: TR
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015192:Infratentorial Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult
keywords: Brainstem; Child; Deglutition disorders; Neurosurgery; Posterior fossa brain tumor