Tapia's Syndrome after Posterior Cervical Spine Surgery under General Anesthesia

We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia's syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.

Application of ProSeal Laryngeal Mask Airway in Posterior Cervical Spine Surgery / 中国微创外科杂志

0.05).One minute after intubation(T3),MAP and HR in the ETT group increased to(12.13?1.37) mm Hg and(96.3?4.7)/min respectively,which were significantly higher than those in the PLMA group [(9.98?1.21) mm Hg,t=6.443,P=0.000;and(88.3?5.6)/min,t=5.947,P=0.000].Three minutes after intubation(T4),the MAP and HR of the two groups were significantly different(P0.05).Five patients in the PLMA group had adverse reaction,that was significantly fewer than that in the ETT group(12 cases)(?2=4.022,P=0.045).Conclusions PLMA is applicable for posterior cervical spine surgery,since it is associated with less stimulation and adverse reaction,and stable hemodynamics.The success rate of intubation is high by using the procedure.