ORIGINAL RESEARCH article
Front. Surg.
Sec. Pediatric Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1645832
This article is part of the Research TopicInnovations in Pediatric Neurosurgery: Techniques and OutcomesView all 8 articles
Sex as an Independent Risk Factor for Cerebellar Mutism Syndrome: A Validation Study
Provisionally accepted
Xiaojiao PengZhuo Zhi
Xinyi Chai
Hong Zhang
Yingjie Cai
Kaiyi Zhu
Nijia ZhangJia WangHailang SunGuangheng Yin
Wenping Ma*
Wei Yang*Ming Ge*- Beijing Children's Hospital Capital Medical University, Beijing, China
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Background: Cerebellar Mutism Syndrome (CMS) is a significant neurological complication following posterior fossa tumor surgery in children. The pathophysiological mechanisms of CMS remain elusive, and there is a growing interest in the potential influence of sex on its incidence. This study aims to evaluate sex as an independent risk factor for the development of CMS. Methods: A retrospective cohort study of 385 pediatric patients who underwent posterior fossa tumor surgery at Beijing Children’s Hospital (2013–2024) was conducted. Comprehensive demographic, clinical, and pathological data were collected. Statistical analysis involved Chi-square tests for categorical variables, Kruskal-Wallis tests for non-parametric comparisons among groups, and logistic regression to identify independent predictors of CMS. Results: CMS occurred in 29.9% of all cases, with annual incidence ranging from 14.3% to 37.9%.. Medulloblastoma was the most common pathology (38.4%), with a median maximal tumor diameter of 47.2 mm. Tumors were predominantly located at the midline (68.1%), and gross total resection was achieved in 86.3% of patients. Male patients exhibited a significantly higher incidence of CMS compared to females (73.0% vs. 53.0%, p = 0.003). Independent risk factors for CMS included male sex (OR 2.25; 95% CI [1.30–3.70]), midline tumor location (OR 7.47; 95% CI [2.79–19.98]), and medulloblastoma diagnosis (OR 2.11; 95% CI [1.24–3.59]). Conclusion: This study indicates a notable male predominance in CMS occurrence, suggesting the existence of sex-specific differences in cerebellar function and language development. These findings highlight the need for heightened monitoring and tailored interventions for male patients undergoing posterior fossa tumor surgery and suggest a potential biological basis for sex-specific differences in cerebellar function and vulnerability to surgical injury.
Keywords: cerebellar mutism syndrome, sex differences, Pediatric Neurosurgery, Posterior FossaTumor, Risk factors
Received: 17 Jun 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Peng, Zhi, Chai, Zhang, Cai, Zhu, Zhang, Wang, Sun, Yin, Ma, Yang and Ge. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenping Ma, Beijing Children's Hospital Capital Medical University, Beijing, China
Wei Yang, Beijing Children's Hospital Capital Medical University, Beijing, China
Ming Ge, Beijing Children's Hospital Capital Medical University, Beijing, China
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