Tags

Type your tag names separated by a space and hit enter

Unilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature.
Acta Otorhinolaryngol Ital. 2006 Aug; 26(4):219-21.AO

Abstract

Extracranial involvement of the recurrent laryngeal nerve and the hypoglossal nerve is known as Tapia's syndrome. Ipsilateral paralysis of the vocal cord and tongue is present. Lesion of these nerves may be a rare complication of airway management. Herein, a case of Tapia's Syndrome complicating transoral intubation during general anaesthesia in a rhinoplasty operation, together with a review of pertinent literature to evaluate the incidence and the possible pathogenic mechanism of the lesion. There are recent reports in the literature on mono or bilateral paralysis of the XII or laryngeal recurrent nerve after use of laryngeal mask with a pathogenic mechanism of compression. Furthermore, there are reports, following oro-tracheal intubation, of recurrent laryngeal paralysis, likely legacies to the compression of the anterior branch of inferior laryngeal nerve by the cuff of the oro-tracheal tube against the postero-medial part of the thyroid cartilage. Hypoglossal nerve damage could be caused by a stretching of the nerve against the greater horn of the hyoid bone by a laryngeal mask or oro-tracheal tube or compression of the posterior part of the laryngoscope or oro-tracheal tube. In our case, the lesion probably occurred as the result of a two-fold compressive mechanism: on one hand, compression by the cuff of the endo-tracheal tube due to excessive throat pack in the oro-pharynx; on the other hand a prolonged stretching mechanism of these nerves may have occurred due to excessive anterior and lateral flexion of the head. From the data reported in the literature, as in our case, complete recovery of function is generally achieved within the first six months. This progressive recovery of function suggests nerve damage of a neuro-praxic type, which is typical of compression injury. In conclusion, the response of this rare complication confirms the importance not only of the position of the head and patient on the operating table but also the meticulous and correct performance of the routine manoeuvres of airway management.

Authors+Show Affiliations

Otolaryngologic Division, Budrio Hospital, AUSL of Bologna, Bologna, Italy. ftesei@yahoo.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

18236639

Citation

Tesei, F, et al. "Unilateral Laryngeal and Hypoglossal Paralysis (Tapia's Syndrome) Following Rhinoplasty in General Anaesthesia: Case Report and Review of the Literature." Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-facciale, vol. 26, no. 4, 2006, pp. 219-21.
Tesei F, Poveda LM, Strali W, et al. Unilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature. Acta Otorhinolaryngol Ital. 2006;26(4):219-21.
Tesei, F., Poveda, L. M., Strali, W., Tosi, L., Magnani, G., & Farneti, G. (2006). Unilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature. Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-facciale, 26(4), 219-21.
Tesei F, et al. Unilateral Laryngeal and Hypoglossal Paralysis (Tapia's Syndrome) Following Rhinoplasty in General Anaesthesia: Case Report and Review of the Literature. Acta Otorhinolaryngol Ital. 2006;26(4):219-21. PubMed PMID: 18236639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature. AU - Tesei,F, AU - Poveda,L M, AU - Strali,W, AU - Tosi,L, AU - Magnani,G, AU - Farneti,G, PY - 2008/2/2/pubmed PY - 2008/3/20/medline PY - 2008/2/2/entrez SP - 219 EP - 21 JF - Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale JO - Acta Otorhinolaryngol Ital VL - 26 IS - 4 N2 - Extracranial involvement of the recurrent laryngeal nerve and the hypoglossal nerve is known as Tapia's syndrome. Ipsilateral paralysis of the vocal cord and tongue is present. Lesion of these nerves may be a rare complication of airway management. Herein, a case of Tapia's Syndrome complicating transoral intubation during general anaesthesia in a rhinoplasty operation, together with a review of pertinent literature to evaluate the incidence and the possible pathogenic mechanism of the lesion. There are recent reports in the literature on mono or bilateral paralysis of the XII or laryngeal recurrent nerve after use of laryngeal mask with a pathogenic mechanism of compression. Furthermore, there are reports, following oro-tracheal intubation, of recurrent laryngeal paralysis, likely legacies to the compression of the anterior branch of inferior laryngeal nerve by the cuff of the oro-tracheal tube against the postero-medial part of the thyroid cartilage. Hypoglossal nerve damage could be caused by a stretching of the nerve against the greater horn of the hyoid bone by a laryngeal mask or oro-tracheal tube or compression of the posterior part of the laryngoscope or oro-tracheal tube. In our case, the lesion probably occurred as the result of a two-fold compressive mechanism: on one hand, compression by the cuff of the endo-tracheal tube due to excessive throat pack in the oro-pharynx; on the other hand a prolonged stretching mechanism of these nerves may have occurred due to excessive anterior and lateral flexion of the head. From the data reported in the literature, as in our case, complete recovery of function is generally achieved within the first six months. This progressive recovery of function suggests nerve damage of a neuro-praxic type, which is typical of compression injury. In conclusion, the response of this rare complication confirms the importance not only of the position of the head and patient on the operating table but also the meticulous and correct performance of the routine manoeuvres of airway management. SN - 0392-100X UR - https://www.unboundmedicine.com/medline/citation/18236639/Unilateral_laryngeal_and_hypoglossal_paralysis__Tapia's_syndrome__following_rhinoplasty_in_general_anaesthesia:_case_report_and_review_of_the_literature_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/18236639/ DB - PRIME DP - Unbound Medicine ER -