Tapia's syndrome following cervical laminoplasty -A case report-

Lim, Kyung-Jee; Kim, Manho; Kang, Minjung; Lee, Hyo Min; Park, Eun Young; Kwon, Kwang-Jun; Lee, Soo Kyung; Choi, Hyun-Soo; Moon, Hyun Soo

doi:10.4097/kjae.2013.64.2.172

Cited by 16 publications

(5 citation statements)

References 14 publications

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“…The administration of intravenous or oral steroids in combinations with B1, B6, B12 vitamins or hialuronic acid injection has been proposed by many authors in the acute setting. At least 4 patients[8,17,23] required percutaneous endoscopic gastrostomy and 2 a naso-gastric tube insertion[20,42] to ensure nutritional requirements while the oro-esofageal route was unable to be used. In two cases (Takimoto[43] and ours), where bilateral paralyses were discovered, reintubation with subsequent tracheotomy was necessary to prevent respiratory failure.…”

Section: Resultsmentioning

confidence: 99%

Isolated bilateral Tapia’s syndrome after liver transplantation: A case report and review of the literature

Bilbao¹,

Dopazo²,

Caralt³

et al. 2016

WJH

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AIMTo describe one case of bilateral Tapia’s syndrome in a liver transplanted patient and to review the literature.METHODSWe report a case of bilateral Tapia’s syndrome in a 50-year-old man with a history of human immunodeficiency virus and hepatitis C virus child. A liver cirrhosis and a bi-nodular hepatocellular carcinoma, who underwent liver transplantation after general anesthesia under orotracheal intubation. Uneventful extubation was performed in the intensive care unit during the following hours. On postoperative day (POD) 3, he required urgent re-laparotomy due to perihepatic hematoma complicated with respiratory gram negative bacilli infection. On POD 13, patient was extubated, but required immediate re-intubation due to severe respiratory failure. At the following day a third weaning failure occurred, requiring the performance of a percutaneous tracheostomy. Five days later, the patient was taken off mechanical ventilation and severe dysphagia, sialorrea and aphonia revealed. A computerized tomography and a magnetic resonance imaging of the head and neck excluded central nervous injury. A stroboscopy showed bilateral paralysis of vocal cords and tongue and a diagnosis of bilateral Tapia’s syndrome was performed. With conservative management, including a prompt establishment of a speech and swallowing rehabilitation program, the patient achieved full recovery within four months after liver transplantation. We carried out MEDLINE search for the term Tapia’s syndrome. The inclusion criteria had no restriction by language or year but must provide sufficient available data to exclude duplicity. We described the clinical evolution of the patients, focusing on author, year of publication, age, sex, preceding problem, history of endotracheal intubation, unilateral or bilateral presentation, diagnostic procedures, type of treatment, follow-up, and outcome.RESULTSSeveral authors mentioned the existence of around 70 cases, however only 54 fulfilled our inclusion criteria. We found only five published studies of bilateral Tapia’s syndrome. However this is the first case reported in the literature in a liver transplanted patient. Most patients were male and young and the majority of cases appeared as a complication of airway manipulation after any type of surgery, closely related to the positioning of the head during the procedure. The diagnosis was founded on a rapid suspicion, a complete head and neck neurological examination and a computed tomography and or a magnetic resonance imaging of the brain and neck to establish the origin of central or peripheral type of Tapia’s syndrome and also the nature of the lesion, ischemia, abscess formation, tumor or hemorrhage. Apart from corticosteroids and anti- inflammatory therapy, the key of the treatment was an intensive and multidisciplinary speech and swallowing rehabilitation. Most studies have emphasized that the recovery is usually completed within four to six months.CONCLUSIONTapia’s syndrome is almost always a transient complication after airway manipulation. Altho...

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Section: Resultsmentioning

confidence: 99%

Isolated bilateral Tapia’s syndrome after liver transplantation: A case report and review of the literature

Bilbao¹,

Dopazo²,

Caralt³

et al. 2016

WJH

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“…CN X and XII in this region might be vulnerable to direct compression by oropharyngeal instrumentation, including a laryngoscope blade, tracheal tube, supraglottic airway device, transesophageal echocardiography probe, or throat pack [1,[3][4][5][6][7][8][9][10]. Excessive head and neck displacement during airway manipulation and surgery might cause malpositioning of these instruments; it might also stretch CN X and XII against the transverse process of the first cervical vertebra, as these nerves cross each other near this process [1,4,5,[7][8][9][10][11][12][13]. Compression and/or stretching of CN X and XII could cause neurapraxia [1-3, 5, 9].…”

Section: Discussionmentioning

confidence: 99%

“…Communication between anesthesiologists and surgeons about posture may prevent this complication. Moreover, close attention should be given to coexisting symptoms in patients with hoarseness, a common complication of general anesthesia; this will ensure the accurate and timely diagnosis of Tapia's syndrome, possibly preventing poor recovery or a life-threatening outcome, such as aspiration [4,11,14]. Fig.…”

Section: Discussionmentioning

confidence: 99%

A case of combined cranial nerve palsy after general anesthesia

Uneda¹,

Yano²,

Imaizumi³

2018

JA Clin Rep

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To the editor We encountered concomitant paralysis of the unilateral vocal cord and tongue after upper extremity surgery under general anesthesia. This presentation is very rare but may be clinically instructive for both anesthesiologists and surgeons. Case presentation A 51-year-old man (165 cm, 81 kg) underwent internal fixation of a left proximal humeral fracture under general anesthesia. After inducing anesthesia with propofol, remifentanil, and rocuronium, an 8.0-mm tracheal tube was placed using a Macintosh blade uneventfully. The depth and intracuff pressure of the tracheal tube were 23 cm and ≤ 12 cmH 2 O, respectively. The 105-min long procedure was performed in the beach-chair position. Anesthesia was uneventful, except for the displacement of the patient's head and neck, which required repositioningthe head and neck were often deflected to the right while traction was applied to the left forearm during fracture reduction. After emergence from anesthesia, the patient was hoarse. On postoperative day 1, he complained of dysarthria, dysphagia, and leftward deviation of the tongue. On postoperative day 2, magnetic resonance imaging of the head did not show any abnormalities. Subsequent swallowing videofluoroscopy and laryngeal endoscopy revealed pharyngeal retention without aspiration and left vocal cord paralysis. He was diagnosed with

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“…There have been several reports on Tapia syndrome associated with oro-tracheal intubation resulted from compression of the recurrent laryngeal and hypoglossal nerves by the cuff pressure of the endotracheal tube and prolonged stretching of these nerves by improper positioning of the head [8,11] in a variety of clinical conditions such as tonsillectomy, septoplasty, [12] shoulder surgery, [13] mediastinal tumor, coronary bypass, [6] carotid artery aneurysm, [14] neurofibroma of vagal, and hypoglossal nerve. [15] From our search of the literature, we believe this is the first report of Tapia's syndrome following breast cancer surgery.…”

Section: Discussionmentioning

confidence: 99%