Posterior fossa tumours in childhood: Associated speech and language disorders post-surgery

Abstract

Six children aged between 6 and 16 years who had undergone surgery for the removal of a posterior fossa tumour were assessed at least one year postoperatively to determine the incidence and severity of any associated speech or language deficits. Five males and one female were included in the sample. The subjects were administered a battery of speech/language assessments including: a language screening test, an articulation test, a dysarthria assessment and a perceptual speech analysis. The results indicated that dysarthria and/or language impairment occurs in some cases subsequent to surgical removal of posterior fossa tumours. The occurrencc of muteness immediately post-surgery would appear to indicate a poor prognosis for speech abilities. A possible link between the occurrence of long term language disabilities in these children and post-surgical radiotherapy is documented.

The Impact of a Cerebellar Tumour on Language Function in Childhood

“…The likelihood for this case to develop more widespread difficulties in high-level language may also exist beyond the current report at both 6 and 18 months following treatment due to an upsurge in reports of neuropathological changes following radiotherapy, including radionecrosis, white matter density changes, intracerebral calcifications and atrophy, which reportedly occur from 6 months up to 20 years later following radiotherapy treatment [8,15,27] . Subsequent to treatment, increasing evidence of intracranial changes may escalate over time, which in turn has the opportunity to impact language function to a greater extent [8,26,31] .…”

“…Surprisingly, unlike neuropsychological effects that have been related to childhood radiation treatment of brain tumour, communication disorders have generally not been commonly linked to radiotherapy [6][7][8]26] . The one documented study that identified a possible connection reported language impairments inclusive of deficits in word finding, syntax and reading [8] .…”

“…Subsequent to treatment, increasing evidence of intracranial changes may escalate over time, which in turn has the opportunity to impact language function to a greater extent [8,26,31] . The potential for even further decline is indicated by these preliminary results associated with increases in time subsequent to treatment completion reported by Hudson et al [8] .…”

“…The one documented study that identified a possible connection reported language impairments inclusive of deficits in word finding, syntax and reading [8] . These discrepancies were reportedly evident only in those children who had received radiotherapy after surgery.…”

“…Results from the group of hemispheric patients also reportedly confirmed the dissociation of the circuits connecting the cerebellum to the supratentorial associative areas through the thalamus [3] . Specific high-level language deficits, global impairment, and expressive language and syntax were also acknowledged among others to be related to direct impact of cerebellar damage [6][7][8] .…”