Tapia’s syndrome following otolaryngologic surgery – A case report

Abstract

Introduction: There are limited report about Tapia’s syndrome since its first discovery in 1904. To bridge the gap, we present a case of the syndrome to highlight the diagnose, root cause analysis, and treatment plans. Patient concerns: A 28-year-old man was admitted to hospital due to nasal septum deviation and perforation. After otolaryngologic surgery under general anaesthesia, the patient complained hoarseness, disturbed speech and right deviation of the tongue. Diagnosis: Neurological examination, laryngoscopy, tongue electromyography, and throat magnetic resonance imaging were performed. The patient was diagnosed with Tapia’s syndrome as a complication of anaesthetic airway management. Interventions: Since the patient refused to receive steroid therapy, ginkgo leaf extract and methylcobalamin, supplemented with mouse nerve growth factor were gave to the patient. Outcomes: Within one month, the patient showed relieved hoarseness and less deviation of tongue to the right. Laryngoscopy has confirmed that the right vocal cord had recovered from paralysis. Conclusion: There is no anatomical relation between otolaryngologic surgery, the hypoglossal nerve and recurrent laryngeal branch of the vagus nerve. This Tapia’s syndrome case is possibly caused by nerve compression of the two nerves due to anaesthesia cannula. Ginkgo leaf extract, methylcobalamin and mouse nerve growth factor could be used as an alternative treatment plan in case of steroid contraindications. Keywords: Tapia's syndrome, Anaesthesia, Paralysis, Hoarseness, Tongue deviation