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Updated: Aug 7, 2026
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Published on: August 15, 2025
Postoperative swallowing function after posterior fossa tumor resection in pediatric patients
Lisa A Newman1, Frederick A Boop, Robert A Sanford
1Department of Otolaryngology, Head & Neck Surgery, The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Insights
Children undergoing posterior fossa tumor surgery often experience swallowing problems. Video fluoroscopic swallow study (VFSS) is crucial for diagnosing aspiration risk and guiding safe feeding post-surgery.
Area of Science:
- Pediatric Neurosurgery
- Swallowing Disorders (Dysphagia)
- Neuroradiology
Background:
- Posterior fossa tumor resection in children frequently leads to postoperative swallowing dysfunction.
- Identifying children at risk for aspiration is critical for preventing complications.
- Bedside swallowing assessments are often insufficient for accurate diagnosis.
Purpose of the Study:
- To document swallowing abnormalities in pediatric patients following posterior fossa brain tumor surgery.
- To recommend management strategies for children at risk of aspiration.
Main Methods:
- Retrospective analysis of 24 children who underwent video fluoroscopic swallow study (VFSS) postoperatively.
- These children were among 127 patients who had posterior fossa tumor resection between 1998 and 2001.
- Evaluation focused on oral, pharyngeal, and cervical esophageal transit.
Main Results:
- Less than half of the evaluated children demonstrated functional swallowing within the first postoperative week.
- Video fluoroscopic swallow study (VFSS) proved effective in diagnosing swallowing dysfunction.
- Children with brain stem involvement and complicated recoveries exhibited significantly poorer swallowing function and higher aspiration rates.
Conclusions:
- Swallowing dysfunction is common after posterior fossa tumor surgery in children.
- Video fluoroscopic swallow study (VFSS) is essential for accurate diagnosis and management.
- Oral feeding should be withheld until a radiographic swallowing assessment confirms safe swallowing function.
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.
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