Sarup, Rebekka;
Laustsen, Aske F;
Sorensen, Martin K;
Mallucci, Conor;
Pizer, Barry;
Aquilina, Kristian;
Molinari, Emanuela;
... Mathiesen, Rene; + view all
(2025)
Glucocorticoid use in paediatric posterior fossa tumour surgery and the occurrence of postoperative speech impairment.
Child's Nervous System
, 41
(1)
, Article 231. 10.1007/s00381-025-06850-0.
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Abstract
Purpose: Postoperative speech impairment (POSI) is a core symptom of cerebellar mutism syndrome (CMS) and is a common complication after the resection of paediatric posterior fossa (PF) tumours. Preoperative glucocorticoids (pGC) are considered standard treatment to reduce tumour oedema; in addition, glucocorticoids are often administered intraoperatively (iGC) to reduce both postoperative nausea and vomiting. The study aims to investigate whether the occurrence of POSI may be associated with pGC and iGC. Methods: In a prospective observational multicentre study, we included children with a PF tumour requiring either resection or open biopsy. The use of pGC and iGC, including drug type and dose, was registered. Postoperative speech status was classified as mutism, reduced speech, or habitual speech, where mutism and reduced speech were considered POSI of higher and lower severity, respectively. Proportional odds logistic regression with adjustment for tumour type, tumour location, and age was used to analyse the occurrence of POSI associated with glucocorticoids (GC). Results: From August 2014 to November 2024, we recruited 810 children, of whom 605 were included in the primary analysis. We found no association between the use of GC (pGC nor iGC) and the occurrence of POSI. The result did not change when adjusting for tumour type, tumour location, and age. The analysis included both a comparison between using and not using pGC (OR 1.06 [95% CI 0.46 –2.49], reference level: use of pGC) and/or iGC (1.28 [0.58–2.82], reference level: use of iGC), and a dose–response analysis of the occurrence of POSI in relation to doubling the dose of GC (pGC OR 1.28 [0.84–1.98]; iGC OR 1.07 [0.62–1.82]). Conclusion: Our study did not find evidence of a significant change in the occurrence of POSI with the use of pGC or iGC, but our results alone cannot rule out that the administration of pGC or iGC may have some effect. Therefore, our data do not call for a change in recommendations for the use of GC as protection against the development of POSI. Trial registration number: Clinicaltrials.gov (NCT02300766). Date of registration: November 25, 2014
| Type: | Article |
|---|---|
| Title: | Glucocorticoid use in paediatric posterior fossa tumour surgery and the occurrence of postoperative speech impairment |
| Location: | Germany |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1007/s00381-025-06850-0 |
| Publisher version: | https://doi.org/10.1007/s00381-025-06850-0 |
| Language: | English |
| Additional information: | Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Pediatrics, Surgery, Neurosciences & Neurology, Cerebellar mutism syndrome, Neurosurgery, Brain neoplasm, Preoperative, Intraoperative, Postoperative speech impairment, CEREBELLAR MUTISM SYNDROME, MANAGEMENT, EDEMA |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214154 |
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