{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:33:42Z","timestamp":1774460022272,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1745141","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T06:38:00Z","timestamp":1767595080000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Tapia syndrome following anterior cervical surgery in a patient with diffuse idiopathic skeletal hyperostosis: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Liuxin","family":"Yan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zihao","family":"Zhen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiming","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1056\/NEJMra2003558","article-title":"Degenerative cervical spondylosis","volume":"383","author":"Theodore","year":"2020","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1038\/nrrheum.2013.165","article-title":"Diffuse idiopathic skeletal 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of Tapia syndrome after posterior cervical spine surgery under oral tracheal intubation general anesthesia","volume":"102","author":"Meng","year":"2022","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"B10","doi-asserted-by":"publisher","first-page":"727","DOI":"10.4055\/cios25021","article-title":"Advancing precision in shoulder arthroplasty: patient-specific instrumentation, navigation, and emerging technologies","volume":"17","author":"Song","year":"2025","journal-title":"Clin Orthop Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"3017","DOI":"10.3390\/jcm13103017","article-title":"The surgical stress response and anesthesia: a narrative review","volume":"13","author":"Ivascu","year":"2024","journal-title":"J Clin Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"114928","DOI":"10.1016\/j.expneurol.2024.114928","article-title":"Subclinical brain manifestations of repeated mild traumatic brain injury are changed by chronic exposure to sleep loss, caffeine, and sleep aids","volume":"381","author":"Everson","year":"2024","journal-title":"Exp Neurol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"41","DOI":"10.3389\/fneur.2013.00041","article-title":"Uncovering latent deficits due to mild traumatic brain injury by using normobaric hypoxia stress","volume":"4","author":"Temme","year":"2013","journal-title":"Front Neurol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"345","DOI":"10.3389\/fneur.2019.00345","article-title":"A tilted axis: maladaptive inflammation and HPA axis dysfunction contribute to consequences of TBI","volume":"10","author":"Tapp","year":"2019","journal-title":"Front Neurol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e10980","DOI":"10.1097\/MD.0000000000010980","article-title":"A case report of Tapia\u2019s syndrome after mastectomy and breast reconstruction under general anesthesia","volume":"97","author":"Jee","year":"2018","journal-title":"Medicine (Baltimore)"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1745141\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T06:38:01Z","timestamp":1767595081000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1745141\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":15,"alternative-id":["10.3389\/fsurg.2025.1745141"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1745141","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]},"article-number":"1745141"}}