Professor Zhang Yangqiong: What to Do When a Child Has Swallowing Difficulties? How to Recover from Unsteady Walking?  

Professor Zhang Yangqiong: What to Do When a Child Has Swallowing Difficulties? How to Recover from Unsteady Walking?  

Source: Sunflower Children's Author: Sunflower Children's Editor: Gaozx Date: December 6, 2023  

The Medulloblastoma Q&A column invites experts in the field of pediatric brain tumors to answer various questions about medulloblastoma. Today, we bring you the 17th issue, and we welcome you to leave your questions in the comments section!  

1. What should you do if your child has swallowing difficulties?  

Swallowing difficulties are one of the complications due to cranial nerve damage after surgery. Swallowing difficulty refers to the disruption in the process of food intake and transportation from the mouth to the stomach, leading to an inability to eat safely and effectively and obtain sufficient nutrition and hydration.

1. Assessment: Physicians and rehabilitation therapists assess the degree of swallowing difficulties in the child to determine if the child is suitable for continued oral intake. Therapists will develop a swallowing function training and rehabilitation plan based on the degree of swallowing dysfunction.

2. Oral intake: If the child is assessed to be fit for continued oral intake, daily monitoring of the child's eating situation is necessary to avoid inadequate intake.

3. Nasogastric feeding: If the swallowing assessment indicates a high risk for oral intake or if the child cannot eat orally, it is necessary to follow the doctor's advice to place a gastric tube for nasogastric feeding to ensure the child's nutritional intake.

2. What to do if your child has a sore throat and is unwilling to eat after chemotherapy?  

Sore throat and swallowing difficulties after chemotherapy are mostly due to the side effects of the treatment. Chemotherapy drugs can irritate the throat nerves, causing swelling and congestion of the throat mucosa, leading to uncomfortable symptoms from mucosal damage. Generally, patients with mild symptoms can improve by drinking more water, adjusting their diet, and maintaining oral hygiene. However, if symptoms are more severe and possibly accompanied by infections or systemic reactions, medication under the guidance of a doctor may be necessary. It's important to rest, keep warm, and enhance the body's constitution. Unless necessary, try not to talk, especially loudly, to reduce strain on the throat and avoid further mucosal damage.

3. What special considerations are there after a child undergoes brain surgery?  

Cranial surgery is quite traumatic, and most patients need to stay in bed for a period of time after brain surgery as this is essential for monitoring their condition and ensuring safety. The first 12 to 24 hours after surgery is critical for observing potential complications such as postoperative hematoma, severe brain edema, and significant brainstem dysfunction. Close monitoring of consciousness, pupil responses, and vital signs is essential, and ensuring that the airway and other drainage tubes are clear is paramount. A child's crying often indicates headache or discomfort, so understanding the reasons for the child's distress can help identify changes in their condition promptly.

Close observation of the patient's condition and enhanced nursing care after surgery can reduce postoperative complications and secondary brain damage, alongside early rehabilitation exercises, to truly facilitate comprehensive recovery.

4. How can children with medulloblastoma recover from unsteady walking?  

Medulloblastoma is a rare and malignant neuroectodermal tumor primarily affecting children. Due to the tumor's location and compressive effects, children may experience unsteady walking and other motor function impairments. The rehabilitation process requires a comprehensive treatment plan.

Here are some common rehabilitation measures: 1. Physical therapy; 2. Gait training; 3. Speech therapy; 4. Occupational therapy; 5. Psychological support; 6. Family education.