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.
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
Study Type
OBSERVATIONAL
Enrollment
247
The diagnostic includes : * Lingual clinical examination * Nasofibroscopy * Ultrasonography
Hôpital Forcilles
Férolles-Attilly, Seine-et-Marne, France
RECRUITINGPrevalence of Tapia's syndrome
The main objective of this study is to determine the prevalence of Tapia syndrome in patients admitted to the weaning unit after prolonged orotracheal intubation in intensive care. The orotracheal intubation is defined as an intubation longer than 48 hours.
Time frame: through study completion, an average of 2 years
Lingual involvment
yes/no/measure of lingual deviation in mm and width of each half of tongue in mm with MEEI software)
Time frame: through study completion, an average of 2 years
Soft palate involvement
yes/no
Time frame: through study completion, an average of 2 years
Determining the factors associated with Tapia syndrome
Determining the factors associated with Tapia syndrome : number of prone sessions, duration of intubation (day), duration of mechanical ventilation (day), tracheostomy duration (day), Cormack-Lehane's class, time to tracheostomy cannula removal (day), the time to resume oral feeding (day), number of days in the ICU, number of days in weaning unit, the number of pulmonary infections during the intubation and tracheostomy period, sex, the size of the intubation probe in mm
Time frame: The day of inclusion
Dysphonia
GRBAS, maximum time of phonation (s), base frequency (Hz), jitter (%), harmonic noise ratio (dB), vocal range (dB), vocal tessitura (dB)
Time frame: After initial swallowing test, maximum 1 week
Dysphagia
Functional oral intake scale (Level 1-Nothing by mouth to Level 7-Total oral diet with no restrictions)
Time frame: through study completion, an average of 2 years
Nasofibroscopy
immobility of one or both vocal cords on nasofibroscopy
Time frame: After initial swallowing test, maximum 1 week
Ultrasound
hyoid-mandibular distance at rest and during swallowing in cm), tongue thickness at rest in cm, geniohyoidien thickness in mm and area in mm2, echogenicity (Heckmatt score), vallecula stasis (yes/no), stasis in the piriform sinuses (yes/no)
Time frame: After initial swallowing test, maximum 1 week
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