Abstract：
BACKGROUND: Children who underwent posterior fossa tumor removal may have spoken or written language impairments. The present systematic review synthesized the literature regarding the language outcomes in this population. Benefits of this work were the identification of shortcomings in the literature and a starting point toward formulating guidelines for postoperative language assessment.
METHODS: A systematic literature search was conducted, identifying studies with patients who had posterior fossa surgery before 18 years of age. Included studies were narratively synthesized to understand language outcomes by language function (e.g., phonology, morphosyntax) at a group and individual level. Furthermore, the influence of several mediators (e.g., postoperative cerebellar mutism syndrome (pCMS), tumor type) was investigated. A critical evaluation of the language assessment tools was conducted.
RESULTS: The narrative synthesis of 66 studies showed that a broad spectrum of language impairments has been described, characterized by a large interindividual heterogeneity. Patients younger at diagnosis, receiving treatment for a high-grade tumor and/or radiotherapy and diagnosed with pCMS seemed more prone to impairment. Several gaps in language assessment remain, such as a baseline preoperative assessment and the assessment of pragmatics and morphosyntax. Further, there were important methodological differences in existing studies which complicated our ability to accurately guide clinical practice.
CONCLUSIONS: Children who had posterior fossa surgery seem to be at risk for postoperative language impairment. These results stress the need for language follow-up in posterior fossa tumor survivors.
METHODS: A systematic literature search was conducted, identifying studies with patients who had posterior fossa surgery before 18 years of age. Included studies were narratively synthesized to understand language outcomes by language function (e.g., phonology, morphosyntax) at a group and individual level. Furthermore, the influence of several mediators (e.g., postoperative cerebellar mutism syndrome (pCMS), tumor type) was investigated. A critical evaluation of the language assessment tools was conducted.
RESULTS: The narrative synthesis of 66 studies showed that a broad spectrum of language impairments has been described, characterized by a large interindividual heterogeneity. Patients younger at diagnosis, receiving treatment for a high-grade tumor and/or radiotherapy and diagnosed with pCMS seemed more prone to impairment. Several gaps in language assessment remain, such as a baseline preoperative assessment and the assessment of pragmatics and morphosyntax. Further, there were important methodological differences in existing studies which complicated our ability to accurately guide clinical practice.
CONCLUSIONS: Children who had posterior fossa surgery seem to be at risk for postoperative language impairment. These results stress the need for language follow-up in posterior fossa tumor survivors.
摘要：
背景：接受后颅窝肿瘤切除术的儿童可能有口语或书面语言障碍。本系统综述综合了有关该人群语言结果的文献。这项工作的好处是发现了文献中的缺点，并为制定术后语言评估指南提供了起点。
方法：进行了系统的文献检索，对18岁之前接受后颅窝手术的患者进行研究。纳入的研究经过叙事综合，以通过语言功能理解语言结果(例如，语音学,形态语法）在团体和个人层面。此外，几个调解人的影响(例如，术后小脑mutism综合征（pCMS），肿瘤类型)进行了调查。对语言评估工具进行了批判性评估。
结果：66项研究的叙事综合表明，已经描述了广泛的语言障碍，以个体间巨大的异质性为特征。诊断时更年轻的患者，接受高级别肿瘤治疗和/或放疗并诊断为pCMS的患者似乎更容易出现损伤.在语言评估方面仍然存在一些差距，例如基线术前评估以及语用和形态语法的评估。Further,现有研究中存在重要的方法学差异，这使得我们准确指导临床实践的能力变得复杂。
结论：后颅窝手术的儿童似乎有术后语言障碍的风险。这些结果强调后颅窝肿瘤幸存者需要语言随访。
方法：进行了系统的文献检索，对18岁之前接受后颅窝手术的患者进行研究。纳入的研究经过叙事综合，以通过语言功能理解语言结果(例如，语音学,形态语法）在团体和个人层面。此外，几个调解人的影响(例如，术后小脑mutism综合征（pCMS），肿瘤类型)进行了调查。对语言评估工具进行了批判性评估。
结果：66项研究的叙事综合表明，已经描述了广泛的语言障碍，以个体间巨大的异质性为特征。诊断时更年轻的患者，接受高级别肿瘤治疗和/或放疗并诊断为pCMS的患者似乎更容易出现损伤.在语言评估方面仍然存在一些差距，例如基线术前评估以及语用和形态语法的评估。Further,现有研究中存在重要的方法学差异，这使得我们准确指导临床实践的能力变得复杂。
结论：后颅窝手术的儿童似乎有术后语言障碍的风险。这些结果强调后颅窝肿瘤幸存者需要语言随访。
