gms | German Medical Science

Objective: Swallowing impairment (dysphagia) has been reported as a possible sequel following surgical removal of posterior fossa tumours (PFT). However, the incidence and time course of dysphagia in these subjects have not been fully elucidated yet. The aim of this study was to prospectively investigate the presence and severity of swallowing disorders in patients with posterior fossa tumors after surgery. In addition, we tried to identify clinical predictors of relevant dysphagia.

Methods: Up to date, 26 consecutive patients with posterior fossa tumors (9 meningiomas, 6 brain metastases, 5 schwannomas, 5 miscellaneous) could be enrolled. All patients were postoperatively assessed (both clinically as well as more sophisticated methods using fiberendoscopic evaluation of swallowing [FEES) by an experienced speech-and-language pathologist (SLP). Patients with relevant dysphagia requiring tube feeding at discharge were followed-up and re-assessed after 3 months.

Results: Following posterior fossa surgery, 15/27 patients (57%) presented with dysphagia with 5 subjects requiring nasogastral tube feeding due to severe swallowing impairment. After 3 months, dysphagia had almost completely resolved in all patients. At initial post-operative assessment, the presence of dysarthria (p=0.03), dysphonia (p=0.01) and cranial nerve affection (p=0.01) proved to be significant predictors of relevant dysphagia requiring dietary modifications.

Conclusion: Dysphagia following posterior fossa brain tumor surgery could be identified in more than 50% of subjects. The presence of dysarthria, dysphonia and cranial nerve affection were useful clinical predictors of relevant dysphagia. Based on the current data, prompt comprehensive postoperative work-up of these patients by an SLP (including FEES) is highly warranted.