Left-handedness should not be overrated as a risk factor for postoperative speech impairment in children after posterior fossa tumour surgery: a prospective European multicentre study

Jonathan Kjær Grønbæk, Aske Foldbjerg Laustsen, Sebastian Toescu, Barry Pizer, Conor Mallucci, Kristian Aquilina, Emanuela Molinari, Magnus Aasved Hjort, Lingvita Gumbeleviciene, Peter Hauser, Beatrix Pálmafy, Kirsten van Baarsen, Eelco Hoving, Julian Zipfel, Christoffer Ehrstedt, Pernilla Grillner, Michael Thude Callesen, Radek Frič, Morten Wibroe, Karsten NysomKjeld Schmiegelow, Astrid Sehested, René Mathiasen, Marianne Juhler, On behalf of The CMS study group

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Abstract

Purpose: Cerebellar mutism syndrome (CMS) is a severe neurological complication of posterior fossa tumour surgery in children, and postoperative speech impairment (POSI) is the main component. Left-handedness was previously suggested as a strong risk factor for POSI. The aim of this study was to investigate the relationship between handedness and the risk of POSI. Methods: We prospectively included children (aged < 18 years) undergoing surgery for posterior fossa tumours in 26 European centres. Handedness was assessed pre-operatively and postoperative speech status was categorised as either POSI (mutism or reduced speech) or habitual speech, based on the postoperative clinical assessment. Logistic regression was used in the risk factor analysis of POSI as a dichotomous outcome. Results: Of the 500 children included, 37 (7%) were excluded from the present analysis due to enrolment at a reoperation; another 213 (43%) due to missing data about surgery (n = 37) and/or handedness (n = 146) and/or postoperative speech status (n = 53). Out of the remaining 250 (50%) patients, 20 (8%) were left-handed and 230 (92%) were right-handed. POSI was observed equally frequently regardless of handedness (5/20 [25%] in left-handed, 61/230 [27%] in right-handed, OR: 1.08 [95% CI: 0.40–3.44], p = 0.882), also when adjusted for tumour histology, location and age. Conclusion: We found no difference in the risk of POSI associated with handedness. Our data do not support the hypothesis that handedness should be of clinical relevance in the risk assessment of CMS.

OriginalsprogEngelsk
TidsskriftChild's Nervous System
Vol/bind38
Nummer8
Sider (fra-til)1479-1485
Antal sider7
ISSN0256-7040
DOI
StatusUdgivet - aug. 2022

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