Bilateral Tapia syndrome after maxillomandibular advancement surgery

Abstract

Hypoglossal and recurrent laryngeal nerve lesions in their unilateral or bilateral extracranial pathways cause a motor deficit in the tongue with transient, partial or total loss of speech, which may be associated with mild or severe dysphagia, characterizing Tapia’s syndrome. This unusual condition is usually related to airway manipulation during the anesthetic-surgical procedure, and few cases in the literature are correlated with maxillofacial surgery, which explains, in part, the lack of knowledge of this complication by a significant number of professionals. We describe a case report of bilateral Tapia syndrome established after a procedure for maxillomandibular advancement. This is a 55-year-old male patient diagnosed with retrognathism and retromaxilism. The patient underwent maxillomandibular advancement with nasotracheal intubation. He evolved with bilateral Tapia syndrome, recovering from the signs and symptoms of this complication, being reoperated on to correct aesthetic results obtained in the first intervention, which were below acceptable, not evolving after this second surgery with the syndrome. We conclude that preventive measures must be taken, such as avoiding sudden movements in the head region and prolonged hyperextension of the neck during surgery, minimizing trauma to the tracheal tube on the tissues that cover the hypoglossal and recurrent laryngeal nerves.