Park Chang Kyu, Lee Dong Chan, Park Chan Joo, Hwang Jang Hoe
Department of Neurosurgery, The Leon Wiltse Memorial Hospital, Suwon, Korea.
Department of Biology, University of California at San Diego, San Diego, CA, USA.
J Korean Neurosurg Soc. 2013 Nov;54(5):423-5. doi: 10.3340/jkns.2013.54.5.423. Epub 2013 Nov 30.
We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia's syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia's syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia's syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.
我们报告一例病例，以提醒外科医生注意这种可能发生在任何手术中的罕见并发症，即使是在全身麻醉下的颈椎后路手术，并讨论其病因、治疗方法及文献中的随访结果。外周性塔皮亚综合征是麻醉气道管理的一种罕见并发症。主要症状为声音嘶哑和舌运动困难。气管内全身麻醉后发生塔皮亚综合征被认为是由于气管导管导致迷走神经和舌下神经受压性神经病变。据我们所知，尚未有关于颈椎后路手术后塔皮亚综合征的报道或解释。两名接受颈椎后路手术的患者术后出现声音嘶哑和舌麻痹。手术与迷走神经和舌下神经之间没有直接的解剖关系，也没有气管导管移位或位置不当的记录。几个月后，所有症状均消失。为避免颈椎后路手术中出现此问题，我们建议特别注意气管导管的位置，避免在患者体位摆放前和摆放过程中颈部过度屈曲。
