CASE REPORT article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicAdvancing Orthopedic Surgery: unique Case Reports driving progressView all 10 articles
Tapia Syndrome Following Anterior Cervical Surgery in a Patient with Diffuse Idiopathic Skeletal Hyperostosis: A Case Report
Provisionally accepted
- The First hospital of Hebei Medical University, Shijiazhuang, China
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Background: Tapia syndrome is a rare complication characterized by concurrent injury to the hypoglossal and vagus nerves, most often associated with airway manipulation during general anesthesia. Patients with diffuse idiopathic skeletal hyperostosis (DISH) present unique anatomical challenges for anterior cervical surgery, increasing the risk of airway-related nerve injury. Case Presentation: We report the case of a 73-year-old man with cervical DISH and myelopathy who underwent anterior cervical corpectomy and fusion (ACCF). Despite an uneventful intraoperative course, the patient developed postoperative hoarseness and delayed airway obstruction due to posterior tongue collapse. Laryngoscopy ruled out vocal cord injury. A diagnosis of Tapia syndrome was made based on the combination of hypoglossal and vagus nerve palsy. The patient required temporary tracheostomy and received glucocorticoid therapy, neurotrophic agents, and rehabilitation. All symptoms gradually resolved, and the patient was discharged after 40 days with near-complete recovery. Conclusion: This case emphasizes the need for careful airway management and early recognition of cranial nerve dysfunction in patients with DISH undergoing anterior cervical surgery. Individualized preoperative anatomical assessment, meticulous intraoperative airway control, and vigilant postoperative monitoring are essential to reduce the risk of this rare but significant complication.
Keywords: Airway Management, Anterior cervical surgery, Cranial nerve injury, Diffuse idiopathic skeletal hyperostosis (DISH), Tapia syndrome
Received: 12 Nov 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Yan, Gao, Zhen and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hongyang Gao
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