Postoperative swallowing function after posterior fossa tumor resection in pediatric patients

Objective: After tumor resection involving the posterior fossa, postoperative swallowing dysfunction may be anticipated. This retrospective study was designed to document swallowing abnormalities in children after posterior fossa brain tumor surgery and to recommend management approaches for children at risk for aspiration. Methods: Twenty-four children referred postoperatively for a video fluoroscopic swallow study (VFSS) out of 127 children undergoing posterior fossa surgery for brain tumor resection from 1998 to 2001 were evaluated for oral, pharyngeal, and cervical esophageal transits. Conclusion: Less than half of the 24 children swallowed functionally within the first week after surgery. VFSS was an appropriate tool for diagnosing swallowing dysfunction, which is impossible to determine at bedside. Children with brain stem involvement and more difficult recovery had significantly worse swallowing function and greater aspiration. We recommend that children with compromised swallowing function should not feed orally until a radiographic swallowing assessment demonstrates functional and safe swallowing with or without therapeutic intervention.