Feeding and swallowing function and dysphagia risk in children with posterior fossa tumors: a preliminary Italian cohort study

Vollständiger Abstract

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Introduction Dysphagia is a frequent postoperative complication in children undergoing surgery for posterior fossa tumors (PFTs), yet early swallowing trajectories remain insufficiently characterized despite the growing focus on functional outcomes in pediatric neuro-oncology. Methods In this prospective cohort study conducted at a tertiary referral center, feeding and swallowing function were assessed at three standardized time points: preoperatively, one week postoperatively, and four weeks postoperatively using the Pediatric Screening Priority Evaluation for Dysphagia (PS-PED), the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) Swallowing Scale, and the Karaduman Chewing Performance Scale (KCPS). Group comparisons were performed according to tumor histology (medulloblastoma [MB], pilocytic astrocytoma [PA], ependymoma [EP]) and extent of resection (partial vs. gross total) using non-parametric methods. Results Forty-five children were enrolled. Across all measures, swallowing function followed a dynamic postoperative trajectory, with substantial deterioration at one week and partial recovery at four weeks; however, many children did not return to their baseline status within this timeframe. Tumor characteristics and surgical factors significantly shaped these trajectories: EPs and MBs were associated with higher dysphagia risk and poorer functional oral intake compared with PAs, and partial resections were consistently linked to worse swallowing outcomes. Chewing performance exhibited a similar pattern of acute decline, followed by gradual improvement, with limited differentiation across subgroups. Discussion These findings underscore the heterogeneity of early postoperative recovery in PFTs, support the integration of serial multidimensional assessments in routine care, and highlight the need for early, individualized rehabilitation strategies to optimize short-term functional outcomes and inform future prognostic research.