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A case report of Tapia's syndrome after mastectomy and breast reconstruction under general anesthesia.
Medicine (Baltimore). 2018 Jun; 97(22):e10980.M

Abstract

RATIONALE

Tapia's syndrome is a rare and potentially anesthesia-related complication that may cause considerable distress to the patient. Here we describe a case of unilateral Tapia's syndrome in a patient undergoing a skin sparing mastectomy and immediate breast reconstruction which, to the best of our knowledge, has not been reported in the literature.

PATIENT CONCERNS

A 41-years old female underwent right skin sparing total mastectomy and breast reconstruction with latissimus dorsi flap under general anesthesia. On the first postoperative day, she complained left sided tongue deviation, subtle hoarseness and swallowing difficulty.

DIAGNOSIS

Tapia's syndrome, a combined paralysis of ipsilateral vocal cord and tongue due to injury to the hypoglossal and recurrent laryngeal nerves, in this case, resulting potentially from head and neck position changes INTERVENTIONS:: The patient was closely observed with the administration of empirical prednisolone 5 mg/day for 3 weeks.

OUTCOMES

One month after the surgery, functions of the tongue and vocal cord were completely resolved.

LESSONS

Particular attention should be paid to the maintenance of adequate cuff pressure, proper position of endotracheal tube and correct neck positioning, especially when procedures taking a long operation time under endotracheal anesthesia and requiring frequent position changes of the patient's head and neck.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University Hospital Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29851851

Citation

Jee, Chan Hee, et al. "A Case Report of Tapia's Syndrome After Mastectomy and Breast Reconstruction Under General Anesthesia." Medicine, vol. 97, no. 22, 2018, pp. e10980.
Jee CH, Kim HJ, Kwak KH. A case report of Tapia's syndrome after mastectomy and breast reconstruction under general anesthesia. Medicine (Baltimore). 2018;97(22):e10980.
Jee, C. H., Kim, H. J., & Kwak, K. H. (2018). A case report of Tapia's syndrome after mastectomy and breast reconstruction under general anesthesia. Medicine, 97(22), e10980. https://doi.org/10.1097/MD.0000000000010980
Jee CH, Kim HJ, Kwak KH. A Case Report of Tapia's Syndrome After Mastectomy and Breast Reconstruction Under General Anesthesia. Medicine (Baltimore). 2018;97(22):e10980. PubMed PMID: 29851851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A case report of Tapia's syndrome after mastectomy and breast reconstruction under general anesthesia. AU - Jee,Chan Hee, AU - Kim,Hyun Jee, AU - Kwak,Kyung-Hwa, PY - 2018/6/1/entrez PY - 2018/6/1/pubmed PY - 2018/6/13/medline SP - e10980 EP - e10980 JF - Medicine JO - Medicine (Baltimore) VL - 97 IS - 22 N2 - RATIONALE: Tapia's syndrome is a rare and potentially anesthesia-related complication that may cause considerable distress to the patient. Here we describe a case of unilateral Tapia's syndrome in a patient undergoing a skin sparing mastectomy and immediate breast reconstruction which, to the best of our knowledge, has not been reported in the literature. PATIENT CONCERNS: A 41-years old female underwent right skin sparing total mastectomy and breast reconstruction with latissimus dorsi flap under general anesthesia. On the first postoperative day, she complained left sided tongue deviation, subtle hoarseness and swallowing difficulty. DIAGNOSIS: Tapia's syndrome, a combined paralysis of ipsilateral vocal cord and tongue due to injury to the hypoglossal and recurrent laryngeal nerves, in this case, resulting potentially from head and neck position changes INTERVENTIONS:: The patient was closely observed with the administration of empirical prednisolone 5 mg/day for 3 weeks. OUTCOMES: One month after the surgery, functions of the tongue and vocal cord were completely resolved. LESSONS: Particular attention should be paid to the maintenance of adequate cuff pressure, proper position of endotracheal tube and correct neck positioning, especially when procedures taking a long operation time under endotracheal anesthesia and requiring frequent position changes of the patient's head and neck. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/29851851/A_case_report_of_Tapia's_syndrome_after_mastectomy_and_breast_reconstruction_under_general_anesthesia_ L2 - https://doi.org/10.1097/MD.0000000000010980 DB - PRIME DP - Unbound Medicine ER -