Tapia's syndrome following the orthognathic surgery under general anaesthesia

Extracranial injury of the hypoglossal nerve and the recurrent laryngeal nerve is known as Tapia's syndrome, which is an extremely rare complication associated with general anaesthesia. We report a case of Tapia's syndrome occurring after orthognathic surgery. A 34-year-old man underwent 2 jaw-orthognathic surgery under general anaesthesia, which consisted of bilateral sagittal split ramus osteotomy, Le Fort I osteotomy and genioplasty. After surgery, the patient complained of hoarseness and some difficulty in swallowing the liquid diet. Four days after surgery when the intermaxillary fixation was removed, the deviation of the tongue to the left side on protrusion was found. The consultation to an otolaryngologist about his hoarseness revealed the left vocal cord paralysis. Finally, the patient was diagnosed as the palsies of the left hypoglossal nerve and left recurrent laryngeal nerve, that is Tapia's syndrome. The lingual and laryngeal functions were recovered 3 months after surgery.