Overview
Tapia syndrome is a rare and poorly understood pathology. It is defined by a concomitant attack of the recurrent (branch of X) and hypoglossal (XII) nerves of peripheral or central origin. It is characterized by the paralysis of a vocal cord and the ipsilateral half of tongue. This damage is most often unilateral but it can also be bilateral. It results in dysphonia and swallowing disorders.
Tapia syndrome is a rare and poorly understood pathology. To date, less than 100 cases have been described in the literature. Previous works are mainly case reports and literature reviews. No prevalence study has been performed to date. Furthermore, disagreements persist regarding the semiology. Indeed, the involvement of the soft palate is not always described.
Description
The main aim of this study was to determine the prevalence of Tapia syndrome in patients admitted to weaning unit after prolonged (>48h) orotracheal intubation in the ICU.
The secondary objectives are to:
- Describe the clinical semiology of Tapia syndrome : lingual involvement, soft palate involvement, impairment of phonation and swallowing ;
- Describe the paraclinical features of Tapia syndrome: recurrent involvement, laryngeal and lingual involvement;
- Identify factors associated with Tapia's syndrome
Eligibility
Inclusion Criteria:
- Hospitalized in weaning unit
- Duration of orotracheal intubation in the ICU greater than 48 hours;
- Glasgow score greater than or equal to 13 ;
- Patient at least 18 years of age at the time of inclusion;
- Affiliation with a social security system or beneficiary of such a system ;
- Oral, free, informed and express consent of the patient.
Exclusion Criteria:
- Known history of ENT or neurological pathologies (stroke, head trauma, neurodegenerative disease, brain tumor, ENT cancer);
- Known tumors in the vicinity of the X-nerve pathway;
- Ortner's syndrome (left recurrent nerve compression through the left atrium in mitral stenosis);
- Left lung cancer with subaortic lesion;
- History of cervical adenopathy compressing the X nerve;
- Presence of a cervical or cerebral abscess;
- 24-hour ventilated patient;
- Refusal of the patient or designated trusted person to participate in the study;
- Person subject to a safeguard of justice measure ;