Journal
CHILDS NERVOUS SYSTEM
Volume 38, Issue 8, Pages 1479-1485Publisher
SPRINGER
DOI: 10.1007/s00381-022-05567-8
Keywords
Cerebellar mutism syndrome; Posterior fossa syndrome; Handedness
Categories
Funding
- Danish Childhood Cancer Foundation
- Swedish Childhood Cancer Foundation
- Brain Tumour Charity (UK)
- Danish Cancer Society
- King Christian IX and Queen Louise's anniversary grant
- Danish Capitol Regions Research Fund
- Dagmar Marshall Foundation
- Rigshospitalet's Research Fund
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According to the study, there is no significant relationship between handedness and postoperative speech impairment. The study does not support the hypothesis that left-handedness should be of clinical relevance in the risk assessment of CMS.
Purpose Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40-3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.
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