Postoperative speech impairment and cranial nerve deficits after secondary surgery of posterior fossa tumours in childhood: a prospective European multicentre study

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Postoperative speech impairment and cranial nerve deficits after secondary surgery of posterior fossa tumours in childhood : a prospective European multicentre study

Gronbaek, J. Kjaer (författare): Copenhagen Univ Hosp, Dept Neurosurg, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.;Copenhagen Univ Hosp, Dept Paediat & Adolescent Med, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.

Toescu, S. (författare): Great Ormond St Hosp Sick Children, Dept Neurosurg, Great Ormond St, London WC1N 3JH, England.;UCL GOS Inst Child Hlth, Dev Imaging & Biophys Sect, 30 Guilford St, London WC1N 1EH, England.,Great Ormond Street Hospital,UCL Institute of Child Health

Fric, R. (författare): Oslo Univ Hosp, Dept Neurosurg, Postboks 4950 Nydalen, N-0424 Oslo, Norway.,Oslo university hospital

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Nilsson, Pelle (författare): Uppsala universitet,Neurokirurgi,Uppsala University Hospital

Castor, C. (författare): Lund University,Lunds universitet,Barns och familjers hälsa,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Child and Family Health,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Alder Hey Children’s NHS Foundation Trust

Mallucci, C. (författare): Alder Hey Childrens NHS Fdn Trust, Dept Paediat Neurosurg, E Prescot Rd, Liverpool L14 5AB, Merseyside, England.

Pizer, B. (författare): Univ Liverpool, Sch Hlth & Life Sci, Brownlow Hill, Liverpool L69 3BX, Merseyside, England.,University of Liverpool

Aquilina, K. (författare): Great Ormond St Hosp Sick Children, Dept Neurosurg, Great Ormond St, London WC1N 3JH, England.,Great Ormond Street Hospital,Helsinki University Central Hospital

Molinari, E. (författare): Univ Glasgow, Queen Elizabeth Univ Hosp, Dept Neurol, Univ Ave, Glasgow G12 8QQ, Lanark, Scotland.,Queen Elizabeth University Hospital, Glasgow

Hjort, M. Aasved (författare): St Olavs Hosp, Dept Pediat Hematol & Oncol, Postboks 3250 Torgarden, N-7006 Trondheim, Norway.,St. Olav’s University Hospital

Karppinen, A. (författare): Helsinki Univ Hosp, Dept Neurosurg, POB 266,N00029, Helsinki, Finland.;Univ Helsinki, POB 266,N00029, Helsinki, Finland.

Rutkauskiene, G. (författare): Lithuanian Univ Hlth Sci, Dept Pediat, Mickeviciaus 9, LT-44307 Kaunas, Lithuania.,Lithuanian University of Health Sciences

Mudra, K. (författare): Semmelweis Univ, Dept Pediat 2, Tuzolto St 79, Budapest, Hungary.

Markia, B. (författare): Natl Inst Mental Hlth, Neurol & Neurosurg, Laky Adolf U 44, H-1145 Budapest, Hungary.

van Baarsen, K. (författare): Princess Maxima Ctr Pediat Oncol, Heidelberglaan 25, NL-3584 CS Utrecht, Netherlands.,Princess Maxima Center for Pediatric Oncology/Hematology

Hoving, E. (författare): Princess Maxima Ctr Pediat Oncol, Heidelberglaan 25, NL-3584 CS Utrecht, Netherlands.,Princess Maxima Center for Pediatric Oncology/Hematology

Zipfel, J. (författare): Univ Hosp Tuebingen, Dept Neurosurg, Pediat Neurosurg, Hoppe Seyler Str 3, D-72076 Tubingen, Germany.,University Hospital of Tubingen

Wibroe, M. (författare): Copenhagen Univ Hosp, Dept Paediat & Adolescent Med, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.,Copenhagen University Hospital

Nysom, K. (författare): Copenhagen Univ Hosp, Dept Paediat & Adolescent Med, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.,Copenhagen University Hospital

Schmiegelow, K. (författare): Copenhagen Univ Hosp, Dept Paediat & Adolescent Med, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.;Univ Copenhagen, Fac Med, Inst Clin Med, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark.,University of Copenhagen,Copenhagen University Hospital

Sehested, A. (författare): Copenhagen Univ Hosp, Dept Paediat & Adolescent Med, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.,Copenhagen University Hospital

Mathiasen, R. (författare): Copenhagen Univ Hosp, Dept Paediat & Adolescent Med, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.,Copenhagen University Hospital

Juhler, M. (författare): Copenhagen Univ Hosp, Dept Neurosurg, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark.;Univ Copenhagen, Fac Med, Inst Clin Med, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark.;Aarhus Univ Hosp, Dept Neurosurg, Blvd 99, DK-8200 Aarhus, Denmark.,University of Copenhagen,Copenhagen University Hospital,Aarhus University Hospital

Grønbæk, J. Kjær (författare): Copenhagen University Hospital

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Copenhagen Univ Hosp, Dept Neurosurg, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark;Copenhagen Univ Hosp, Dept Paediat & Adolescent Med, Rigshosp, Blegdamsvej 9, DK-2100 Copenhagen E, Denmark. Great Ormond St Hosp Sick Children, Dept Neurosurg, Great Ormond St, London WC1N 3JH, England.;UCL GOS Inst Child Hlth, Dev Imaging & Biophys Sect, 30 Guilford St, London WC1N 1EH, England. (creator_code:org_t)

2022-02-14
2022
Engelska.
Ingår i: Child's Nervous System. - : Springer Nature. - 0256-7040 .- 1433-0350. ; 38:4, s. 747-758

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Purpose Brain 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. Methods In 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. Results We 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). Conclusion Children 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

Cerebellar mutism syndrome
Posterior fossa syndrome
Secondary resection
Posterior fossa tumour
Cerebellar mutism syndrome
Posterior fossa syndrome
Posterior fossa tumour
Secondary resection

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

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