INTRINSIC TUMORS OF THE MEDULLA - PREDICTING OUTCOME AFTER SURGERY

Twenty-four children and young adults who underwent surgery for intrin sic tumors of the medulla were studied, correlating preoperative sympt oms to postoperative brain stem dysfunction. 75% harbored benign tumor s with a mean survival of 3.6 years, while the remaining 25% with anap lastic tumors had a mean survival of 3.2 years. Six patients required postoperative ventilatory support for an extended period of time, and 9 required feeding gastrostomies. Those patients who experienced frequ ent symptoms of upper respiratory tract infection, preoperative pneumo nia, or an alteration in their voice were at risk of postoperative ven tilatory dependency. Those without such symptoms did not experience su ch a fate. Difficulty in swallowing food or liquids seems to predict t he need for postoperative feeding gastrostomies, and a lack of such a history was correlated with no such need 100% of the time. There seem to be preoperative signs and symptoms which predict postoperative brai n stem dysfunction for an extended period of time in those undergoing brain stem surgery for tumors intrinsic to the medulla.