Tapia syndrome , also called matador's disease, is a rare syndrome that is characterized by unilateral paralysis of the tongue and vocal cords. Although the problem typically occurs after anesthetic airway management or manipulation, it can be due to central causes in rare cases 11. The syndrome often presents as a feeling of stroke 9,10 that occurs due to simultaneous extra cranial paralysis of recurrent laryngeal branch of vagus nerve and hypoglossal nerve 1,2,5.
The classic clinical scenario of Tapia syndrome is 4-6:
- hoarseness of voice
- tongue movement difficulty
- swallowing difficulty
The following mechanisms have been proposed in the pathogenesis of peripheral iatrogenic Tapia syndrome:
- inaccurate usage of laryngoscope
- intensified neck extension during anesthesia manipulation
- prolong tension over trachea due to overinflation of endotracheal cuff
extensive compression from throat packs over trachea 4,5,7.
History and etymology
This syndrome is eponymously named after the Spanish physician Antonio Garcia Tapia who first described it in a bullfighter, or "matador" wounded by a bullhorn in the neck. The syndrome has therefore sometimes been referred to as matador's disease.
- 1. Paolo Cariati, Almudena Cabello, Pablo P. Galvez, Dario Sanchez Lopez, Blas Garcia Medina. Tapia’s syndrome: pathogenetic mechanisms, diagnostic management, and proper treatment: a case series. (2016) Journal of Medical Case Reports. 10 (1): 1. doi:10.1186/s13256-016-0802-1
- 2. Tesei F, Poveda LM, Strali W, Tosi L, Magnani G, Farneti G. Unilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature. (2006) Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale. 26 (4): 219-21. Pubmed
- 3. Kerolus M, Kerolus TM, Kerolus O3, Kerolus TJ, Kerolus. An Unusual Presentation of Tapia Syndrome Mimicking a Partial Wallenberg Syndrome Following Anterior Cervical Spine Surgery. (2018) Journal of neurosurgical anesthesiology. doi:10.1097/ANA.0000000000000443 - Pubmed
- 4. Lykoudis E, Lykoudis SK, Lykoudis. Tapia's syndrome: an unexpected but real complication of rhinoplasty: case report and literature review. (2012) Aesthetic plastic surgery. doi:10.1007/s00266-011-9849-y - Pubmed
- 5. Boisseau N, Boisseau RH, Boisseau GD, Boisseau RAM, Boisseau. Tapia's syndrome following shoulder surgery. (2002) British journal of anaesthesia. doi:10.1093/bja/88.6.869 - Pubmed
- 6. Tesei F, Poveda LM, Strali W, Tosi L, Magnani G, Farneti G. Unilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature. (2006) Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale. 26 (4): 219-21. Pubmed
- 7. Johnson T, Johnson MH, Johnson. Cranial nerve X and XII paralysis (Tapia's syndrome) after an interscalene brachial plexus block for a left shoulder Mumford procedure. (1999) Anesthesiology. doi:10.1097/00000542-199901000-00040 - Pubmed
- 8. S noA, S MnGmM, S CCA, S. Jugular paraganglioma presenting as Tapia syndrome. (2020) Neurologia (Barcelona, Spain). doi:10.1016/j.nrl.2019.01.007 - Pubmed
- 9. Ildem Deveci, Mehmet Surmeli, Reyhan Surmeli. A Challenging Case of Tapia Syndrome After Total Thyroidectomy:. (2019) Ear, Nose & Throat Journal. doi:10.1177/0145561319841202?url_ver=Z39.88-2003
- 10. Coninckx M, Coninckx CS, Coninckx HD, Coninckx. Tapia's syndrome in the intensive care unit: a rare cause of combined cranial nerve palsy following intubation. (2015) Acta neurologica Belgica. doi:10.1007/s13760-015-0500-6 - Pubmed
- 11. M. Krasnianski, S. Neudecker, A. Schlüter, U. Krause, M. Winterholler. Central Tapia’s syndrome (“matador’s disease”) caused by metastatic hemangiosarcoma. (2003) Neurology. 61 (6): 868. doi:10.1212/01.WNL.0000080370.43712.AA - Pubmed