Management of postoperative swallowing dysfunction after ependymoma surgery

Jerome W. Thompson, Lisa Newman, Frederick Boop, Robert A. Sanford

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Purpose: This study aims to share a new postoperative care technique team approach for the management of children after they have recovered from the anesthetic and has passed through the immediate postoperative period of a day or so from their posterior fossa ependymoma surgery. Methods: A team approach was developed consisting of a neurosurgeon, an otolaryngologist, an intensivist, and a speech pathologist/swallowing specialist. Patients were extubated 24 h after their surgery. Vocal cord function was assessed by fiberoptic exam after extubation. Tracheostomy was occasionally necessary to secure the airway. Swallowing was assessed via modified barium swallow. Aspiration with feeding was occasionally detected early and managed with a gastrostomy tube. Results: Forty-five patients have undergone posterior fossa surgery at our institution and were managed by our team. Nine have had sufficient vocal cord dysfunction to require a tracheostomy. Eleven have required a gastrostomy. None developed respiratory distress and none developed aspiration pneumonia. Conclusions: A team approach, delayed airway evaluation, and modified swallowing exams have benefited our patients after posterior fossa ependymoma surgery. We have prevented any cases of respiratory distress or aspiration pneumonia.

Original languageEnglish (US)
Pages (from-to)1249-1252
Number of pages4
JournalChild's Nervous System
Volume25
Issue number10
DOIs
StatePublished - Oct 1 2009

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Ependymoma
Deglutition
Aspiration Pneumonia
Gastrostomy
Tracheostomy
Vocal Cord Dysfunction
Postoperative Care
Vocal Cords
Barium
Postoperative Period
Anesthetics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Management of postoperative swallowing dysfunction after ependymoma surgery. / Thompson, Jerome W.; Newman, Lisa; Boop, Frederick; Sanford, Robert A.

In: Child's Nervous System, Vol. 25, No. 10, 01.10.2009, p. 1249-1252.

Research output: Contribution to journalReview article

Thompson, Jerome W. ; Newman, Lisa ; Boop, Frederick ; Sanford, Robert A. / Management of postoperative swallowing dysfunction after ependymoma surgery. In: Child's Nervous System. 2009 ; Vol. 25, No. 10. pp. 1249-1252.
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