Incidence of mutism, dysarthria and dysphagia associated with childhood posterior fossa tumour

Abstract

Dysarthria and dysphagia are known complications following posterior fossa tumour (PFT) surgery. Outcome studies for these disorders, however, have focused on a select sub-group of children with mutism. Little is known regarding the incidence or features of these impairments in a consecutively admitted sample of children with PFT. This study describes the incidence and features of mutism, dysarthria and dysphagia during the acute post-surgical phase in a consecutive sample of children with PFT, unselected for the presence of mutism. A retrospective medical chart review of children aged 2 to 18 years consecutively admitted with PFT between January 2003 and January 2008 was conducted. Twenty-seven children with PFT were identified. Post-surgical mutism, dysarthria and dysphagia were recorded in 9/27 (33%), 8/27 (30%) and 9/27 (33%) cases, respectively. Dysarthria most commonly involved deficits in articulation; however, impairments in respiration, phonation and prosody were also reported. Dysphagia involved all stages of swallowing (i.e., pre-oral anticipatory, oral preparatory, oral and pharyngeal). Eighty-nine percent of children (8/9) presented with dysphagia at hospital discharge. The incidence of acute presentation of mutism, dysarthria and dysphagia post-surgery was relatively high, affecting around one in three cases. This incidence rate, considered together with the fact that over half of all cases had co-morbid communication or swallowing impairments, suggests that health professionals should be aware of the likelihood of dysarthria and dysphagia presentation in the acute period and consider speech pathology referral where necessary.