Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishilu, West District, Beijing, 100045, China.
Department of Neonatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Cerebellum. 2023 Aug;22(4):730-738. doi: 10.1007/s12311-022-01449-6. Epub 2022 Jul 23.
The aim of this study was to explore the association between sex and cerebellar mutism syndrome and to examine other potential risk factors. This ambispective cohort study examined 218 pediatric patients (132 boys) with a posterior fossa tumor who underwent tumor resection from July 2013 to March 2021. The patients' demographics and tumor characteristics were examined and statistically analyzed to explore the associations among the variables. Multivariable and subgroup analyses were conducted to validate the independent risk factors for cerebellar mutism syndrome (CMS). The male and female patients did not differ significantly in terms of age, tumor size, tumor location, tumor consistency, VP shunt placement before resection, extent of resection, or surgeon, as well as with respect to the presence of hydrocephalus or paraventricular edema. The overall incidence of CMS was 32.6%. The incidence of CMS was significantly higher in male patients than that in female patients (41.7% vs. 18.6%; P = 0.001). In the multivariable analysis, male sex (adjusted odds ratio [OR], 3.27; P = 0.001), solid tumor consistency (adjusted OR, 5.61; P = 0.001), midline location (adjusted OR, 3.78; P = 0.004), and hydrocephalus (adjusted OR, 2.56; P = 0.047) were independent risk factors for the CMS. Chi-square analysis revealed that solid tumor consistency and midline location were associated with medulloblastoma (P < 0.001). Male patients had a higher risk of developing CMS after a posterior fossa tumor resection. Midline location, solid tumor consistency, and hydrocephalus were independent risk factors for CMS.
本研究旨在探讨性别与小脑缄默症（CMS）之间的关联，并研究其他潜在的风险因素。这项回顾性队列研究纳入了 218 例（男 132 例）后颅窝肿瘤患儿，这些患儿于 2013 年 7 月至 2021 年 3 月期间接受了肿瘤切除术。研究人员对患儿的人口统计学特征和肿瘤特征进行了检查和统计学分析，以探讨各变量之间的关联。进行了多变量和亚组分析，以验证 CMS 的独立风险因素。对男性和女性患者的年龄、肿瘤大小、肿瘤位置、肿瘤一致性、肿瘤切除前的 VP 分流放置、切除范围、手术医生、脑积水或室周水肿的存在情况进行了比较，结果显示这些因素在两组间无显著差异。CMS 的总发生率为 32.6%。男性患者 CMS 的发生率显著高于女性患者（41.7% vs. 18.6%；P = 0.001）。多变量分析显示，男性（调整后优势比 [OR]，3.27；P = 0.001）、肿瘤实性成分（调整后 OR，5.61；P = 0.001）、中线位置（调整后 OR，3.78；P = 0.004）和脑积水（调整后 OR，2.56；P = 0.047）是 CMS 的独立危险因素。卡方分析显示，肿瘤实性成分和中线位置与髓母细胞瘤相关（P < 0.001）。男性患者在后颅窝肿瘤切除术后发生 CMS 的风险更高。中线位置、肿瘤实性成分和脑积水是 CMS 的独立危险因素。
