Síndrome de Tapia tras intubación orotraqueal: a propósito de un caso / Tapia syndrome following orotracheal intubation: A case report

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Tapia's Syndrome.

More than 100,000 general anesthetic procedures are conducted in United Kingdom every year for dental interventions, according to large survey of the National Health Services. 1 The risk of mortality has reduced considerably in the past few decades because of the use of safe and effective techniques. However, adverse effects still exist and are dependent on patient, environmental, and operator factors. We present an uncommon complication of intubation that merits due awareness.

Acute tongue swelling, the only initial manifestation of carotid artery dissection: a case report with differentiation of clinical picture.

While it is well known that carotid artery dissection can cause hypoglossal palsy, which can cause muscle atrophy and fat tissue replacement in the chronic stage but what is less well known is the acute edematous stage, which can mimic tongue angioedema. We present a case report of a 52-year-old man presented to accident and emergency department with 3 hr history of right-side tongue swelling. He was initially diagnosed with angioedema and treated with corticosteroids and antihistamines. His tongue swelling persisted and subsequently developed unilateral weakness. Magnetic resonance imaging scan of the tongue, head, and neck revealed denervation of the right half of the tongue because of injury to hypoglossal nerve during extracranial internal carotid artery (ICA) dissection. There was no evidence of ischemic complication of right cerebral artery distribution. He was commenced on antiplatelet therapy to prevent cerebral ischemia as a prophylactic measure. Swelling and weakness of the tongue subsided in the following months. We believe that hypoglossal palsy caused by ICA dissection should be considered in the differential diagnosis of patients who present with acute tongue swelling.

Diagnosing Tapia syndrome using a videofluoroscopic swallowing study and electromyography after anterior cervical spine surgery.

A couple of the most common complications after anterior cervical spine surgery are dysphagia and hoarseness. This is often related to recurrent laryngeal nerve palsy and it can also be caused by injury to the branches of the lower cranial nerves. In general, Tapia syndrome is combined injuries of the recurrent laryngeal nerve of the vagus and the hypoglossal nerves. There has been no reported case until now of Tapia syndrome after a patient underwent anterior cervical spine surgery. We present here the case of a 42-yr-old man who complained of hoarseness, dysphagia, and right deviation of the tongue with an atrophic change for 2 mos after he underwent C3-4 discectomy and anterior fusion body. We found that he has a diagnosis of a variant of Tapia syndrome, although recurrent laryngeal nerve injury did not seem to be involved according to a videofluoroscopic swallowing study and electromyography. Our case report demonstrates that the combined diagnostic tools of videofluoroscopic swallowing study, electromyography, and laryngoscopy can be very useful in localizing and evaluating the level of lesions in patients with Tapia syndrome.