Tapia综合征的言语治疗康复1例

Daniella Spacassassi, Lia Flávia Pereira
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引用次数: 1

摘要

Tapia综合征的特点是喉返神经(第x支)和舌下神经(第XIIth)受损,在某些情况下,副神经(XIth)也可能受到影响。原因通常是创伤到舌下神经和迷走神经相交的地方。这导致舌偏瘫,声带麻痹和吞咽困难。目的:介绍一例咽旁间隙肿瘤切除后伴Tapia综合征的言语治疗结果。病例报告:男性,71岁,行迷走神经神经鞘瘤切除术,伴腮腺侵袭。伴随:构音障碍;严重的吞咽困难;缺乏流量控制;言语障碍;面瘫和呼吸困难。术后6个月,在环咽肌和唾液腺进行甲状腺成形术和肉毒杆菌毒素注射,确保了声音和唾液流动控制的暂时改善。结果:康复过程包括刺激负责面部模仿的肌肉的活动,重新整合口颌功能,吞咽和声音。经过两年的语言治疗,患者的面部模仿肌肉的活动能力有所改善,发声模式略有改善,呼吸模式也有所改善。结论:尽管在术后期间遇到了局限性和功能复杂性,但有证据表明,在进行临床程序结合治疗过程后,患者的生活质量得到了改善。
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Speech therapy rehabilitation in Tapia´s syndrome: case report
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.
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