Available online 11 January 2013
Publication year: 2013
Source:World Neurosurgery
Objective Our study seeks to assess the incidence of aspiration and prolonged dysphagia needing enteral feeding at discharge (EFD) in adults after posterior fossa surgery. Methods A retrospective review was done on 56 patients with posterior fossa surgery that needed a swallowing evaluation post operatively. Questionnaires were sent to patients with EFD. Using univariate and multiple logistic regression (MLR) analysis, risk factors for aspiration, EFD, and continued enteral feeds were identified. Results Most patients were male and had p-fossa tumors. Multiple swallowing evaluations were needed in 25 (45%) patients. Aspiration was seen in 23 (41%) and 16 (27%) had EFD. Older age and number of evaluations were significantly associated with both aspiration and EFD (p<.05). Lateral approach was significantly associated with EFD (p=0.047). In addition, MLR identified aspiration as an independent significant predictor for EFD (p<.01). Mean operative time and tumor location did not have a significant correlation with EFD. At mean follow-up (15 months) only 5/16 needed continued enteral feeds. Conclusion Although 27% patients had EFD after posterior fossa surgery, only 5/56 (9%) required continued enteral feeding. Aspiration, age and lateral surgical approach is associated with EFD. In patients that demonstrate aspiration, we recommend placement of enteral feeding tube. Though most will not require continued enteral feeding at follow-up, longer follow-ups are needed.
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