Tapia’s syndrome : Definition, Assessment and Rehabilitation

Abstract

Tapia’s syndrome is a rare and misunderstood pathology. It is defined by a concomitant lesion of the recurrent nerves (branch of X) and hypoglossus (XII) of peripheral or central origin. Clinically, it is manifested by a paralysis of a vocal cord and unilateral tongue palsy on the same side, which can lead to swallowing and phonation disorders. Orotracheal intubation is the most common etiology for peripheral origin.

The diagnosis is essentially clinical with the examination of the oro-myofacial functions and the cranial pairs. Tongue deviation or immobility must raise suspicion of this syndrome. A nasofibroscopy is necessary to visualize the paralysis of the ipsilateral vocal cord and to confirm the diagnosis.

Speech therapy targets mobility and tongue tone as well as compensation for recurrent paralysis to improve swallowing and regain a functional voice.

In intensive care units, failure to recognize this syndrome can delay treatment, postponing the resumption of oral feeding and exposing the patient to a risk of aspiration pneumonia. Speech therapy is part of the recommendations of the French Society of Orl and Face and Neck Surgery for recurrent paralysis.