Tapia's syndrome in post-operative patient following orotracheal intubation. (July 2022)

• Record Type: Journal Article
• Authors: Neupane, Sandhya kiran; Poudel Jaishi, Prakash; Acharya, Aakash; Neupane, Prabhat Kiran; Koirala, Divyaa; Joshi, Kusum
• Is Part Of: Annals of medicine and surgery. Volume 79(2022)
• Publication Date: 2022-07
• Subjects: Case report -- Tapia's syndrome -- Post-intubation -- Uvula -- Tongue -- Deviation; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104043
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Tapia's syndrome is a rare condition that manifest due to unilateral extracranial nerve extension of cranial nerve 10 and 12 which occurred as a rare complication of Orotracheal Intubation in patient undergoing Laparoscopic appendectomy. Case presentation: A 30 year old male, a known case of normal variant Right bundle branch block and Gilbert syndrome underwent orotracheal intubation prior to general anesthesia for emergency laparoscopic appendectomy. Postoperatively while assessing the patient there was deviation of tongue on left side. Clinical findings and investigations: On examination of throat, atrophic and deviated uvula toward the right side was found. While protruding his tongue, tongue was deviated towards left side.Neurological examination revealed sluggish Gag Reflex. Brain Ct was done, which showed normal scan. Interventions and outcome: Tablet Prednisolone and logopedic therapy in combination helped in early recovery; which is almost 8 weeks. Patient was completely recovered in 2 month with gradual improvement of phonation, tongue tone and mobility. Relevance and impact: The intent of this report is to show how important it is for anesthesia providers and surgeons to understand Tapia's syndrome, its causes, and the fact that it can occur despite seemingly normal airway care and neck posture. We believe that by raising awareness of this uncommon issue, practitioners will be able to early identify this complication. Highlights: Tapia's syndrome manifest due to unilateral extracranial nerve extension of cranial nerve 10 and 12. It may present as a rare complication of Orotracheal Intubation. Ipsilateral motor paralysis of the tongue and vocal cords is a symptom of this illness. Early logopedic therapy along with steroid reduces the duration of illness. It is critical to obtain a fast diagnosis so that treatment and rehabilitation can begin as soon as possible.