Oropharyneal Dysphagia as a Complication After Cerebellar-Pontin Angle Tumors’ Surgery

Abstract

Introduction
CPA tumor’s treatment may lead to cranial nerve paresis (V, VII, IX–XII).

Material and methods
Part I: Retrospective analysis of 456 FEES reports (I’2015–III’2020), 24 results of patients with CPA tumor were selected (14 men, 10 women, age 22–72). FEES examination according to protocol: anatomy and physiology assessment, oral tests, effectiveness of therapeutic manoeuvres. Agree for nutritional assessment (n = 4).

Part II: Prospective; clinical swallowing examination before and after CPA tumor surgery: 10 consecutive patients (I–VI’2029, 8 men, 2 women, age 18–67).

Results
Part I: Dysphagia was most often related to pharyngeal phase (91%). In the case of the oral phase, the most common were: difficulties in bolus preparation (41%), premature swallowing (20%) and leaking (20%). In the pharyngeal phase: absence of larynx reflex (66%), penetration (70%), residue and multiswallows (54%). The most frequently nerves paresis were: VII (62%), X (62%) and IX (45%); Most patients required adaptive (91%) and compensatory (66%) therapy. NF2 group: 83.33% of patients had multiple cranial nerve paresis (VII, IX, X). Problems with larynx elevation led to penetration (90%) and aspiration (60%). Residue connected with multiswallows (56%). Paralysis of n. XII was connected with bolus preparation problems and premature swallows (83%). Risk of malnutrition (25% of patients).

Part II: Post-operative CSE showed: impaired motor control of the tongue (30%), lips (40%), n. VII paresis (70%), reduction in the jaw extend, 3-times increase
of positive result in a water screening test.
Discussion
Swallowing disorders are a significant problem after CPA surgery, connected with swallowing safety and efficiency. Patients should undergo screening tests, clinical and instrumental examination.