Speech therapy rehabilitation in Tapia´s syndrome: case report

Abstract

Tapia’s syndrome is charaterized by damage to the recurrent laryngeal nerve (branch of the Xth) and the hypoglossal nerve (XIIth), and in some cases, the accessory nerve (XIth) may also be affected. The cause is usually trauma to the point where the hypoglossal and vagus intersect. This results in lingual hemiparesis, vocal fold paralysis and dysphagia. Objective: to present the results of speech therapy in a case that evolved with Tapia´s Syndrome after the excision of a tumour in the parapharyngeal space. Case report: male patient, 71 years old, submitted to excision of a Schwannoma in the vagus nerve, with parotid invasion. Evolved with: dysarthria; severe dysphagia; lack of flow control; dysphonia; facial paralysis and dyspnoea. Six months after surgery, thyroplasty and botulinum toxin injections were performed in the cricopharyngeal muscle and salivary glands, which ensured a temporary improvement in voice and control of salivary flow. Results: The rehabilitation process consisted of stimulating the mobility of the muscles responsible for facial mimicry, reintegration of stomatognathic functions, swallowing and voice. After two years of speech therapy, the patient showed improvement in the mobility of the facial mimic muscles, a slight improvement in the vocal pattern, in addition to an improvement in the breathing pattern. Conclusion: despite the limitations and functional complexities encountered in the postoperative period, there was evidence of improvement in the patient’s quality of life after performing clinical procedures combined with the therapeutic process.