Tumour volume as a predictor of postoperative speech impairment in children undergoing resection of posterior fossa tumours: a prospective, multicentre study

• DOI: 10.1007/s00701-025-06459-x
• Publication Date: 2025-04-04T21:30:23Z
• Authors: Aske Foldbjerg La...; Shivaram Avula; Jonathan Grønbæk; Barry Pizer; Per Nyman; Pelle Nilsson; Radek Frič; Magnus Aasved Hjort; Vladimír Beneš; Peter Hauser; Beatrix Pálmafy; Giedre Rutkauskiene; Florian Wilhelmy; Rick Brandsma; Astrid Sehested; René Mathiasen; Marianne Juhler
• Keywords: Neuroradiology; Ependymoma

Cerebellar Mutism Syndrome (CMS) is a neurological complication of posterior fossa (PF) tumour surgery in children, and postoperative speech impairment (POSI) the cardinal symptom CMS. The role volume on risk POSI remains unexplored. This study investigates association between POSI. We included 360 patients from European CMS with available preoperative T1-weighted contrast-enhanced brain MRI. Speech status was assessed within two weeks postoperatively categorised into three levels: habitual speech, severely reduced mutism. Tumour volumes were calculated using BrainLab Elements SmartBrush™, semi-automated segmentation tool. used proportional odds models to estimate ratio (OR) adjustments for location, pathology, age. Based primary analysis, stratification model medulloblastoma constructed, optimal cut-off determined Youden's Index. found no effect overall result did not change when adjusted an (unadjusted OR 1.04 per increase cm3 (95% CI 1.01;1.07, p = 0.01)), which adjusting location be 16,5 cm3. Patients below had absolute 13% (low-risk group), whereas above 50% (high-risk group). Our data showed children medulloblastoma, while other types. suggest straightforward assessing based volume. approach can aid clinicians informing parents about complications related following PF children. ID NCT02300766 (October 2014).