Electroacupuncture as an effective therapy for Tapia's syndrome after transoral intubation for general anesthesia: a case report and review of the literature.

BACKGROUND: Tapia's syndrome is a rare complication of airway manipulation under general anesthesia. Injuries to the vagus nerve (X) and hypoglossal nerve (XII) during transoral intubation are the primary cause of the disease. The typical symptoms include hoarseness, dysarthria, dysphagia, tongue muscle atrophy, and tongue deviation toward the affected side. We report a case of Tapia's syndrome treated with electroacupuncture to accelerate the recovery process, and discuss the potential mechanism behind our findings based on previous research. CASE PRESENTATION: In this report, we describe a 57-year-old Chinese man who suffered Tapia's syndrome after craniotomy evacuation of hematoma with general anesthesia and transoral intubation. After 52 days of electroacupuncture therapy along with standard swallowing training, the patient achieved significant improvement in deglutition and speech function. CONCLUSION: Electroacupuncture is effective and safe for Tapia's syndrome. It can shorten the recovery time when combined with routine swallowing rehabilitation.

[Ultrasound-guided electroacupuncture at suprahyoid muscle group for pharyngeal dysphagia after stroke: a randomized controlled trial].

OBJECTIVE: To compare the effect among ultrasound-guided electroacupuncture (EA) at suprahyoid muscle group, conventional acupuncture and conventional EA at suprahyoid muscle group on pharyngeal dysphagia after stroke, and to explore its biomechanical mechanism. METHODS: A total of 120 patients with pharyngeal dysphagia after stroke were randomly divided into an observation group, a control-1 group and a control-2 group, 40 cases in each group. The patients in the observation group were treated with ultrasound-guided EA at suprahyoid muscle group; the patients in the control-1 group were treated with EA at Lianquan (CV 23), Wangu (GB 12) and Fengchi (GB 20), etc.; the patients in the control-2 group were treated with EA at suprahyoid muscle group according to anatomical location. The EA in the three groups were discontinuous wave, with frequency of 5 Hz and current intensity of 1 mA. The EA was given for 30 minutes, once a day, 6 times were taken as a course of treatment, and 4 courses of treatment were provided. The video floroscopic swallowing study (VFSS) was performed before and after treatment. The Rosenbek penetration-aspiration scale (PAS) score, the forward and upward movement distance of hyoid bone and thyroid cartilage, Ichiro Fujima ingestion-swallowing function score were recorded in the three groups, and the incidences of subcutaneous hematoma were recorded after treatment. RESULTS: Compared before treatment, the PAS scores were reduced and the Ichiro Fujima ingestion-swallowing function scores were increased after treatment in the three groups (P<0.05); the PAS scores in the observation group were lower than those in the control-1 group and the control-2 group, and the Ichiro Fujima ingestion-swallowing function scores in the observation group were higher than those in the control-1 group and the control-2 group (P<0.05). After treatment, the forward and upward movement distance of hyoid bone and thyroid cartilage in the observation group and the control-2 group was increased (P<0.05), and the forward and upward movement distance of hyoid bone was increased in the control-1 group (P<0.05); the forward and upward movement distance of hyoid bone and thyroid cartilage in the observation group was longer than that in the control-1 group and the control-2 group (P<0.05). The incidence of subcutaneous hematoma in the observation group was 0% (0/40), which was lower than 20.0% (8/40) in the control-1 group and 47.5% (19/40) in the control-2 group (P<0.05). CONCLUSION: Ultrasound-guided EA at suprahyoid muscle group could improve the swallowing function in patients with pharyngeal dysphagia after stroke by increasing the motion of hyoid laryngeal complex. Its effect and safety are better than conventional acupuncture and conventional EA at suprahyoid muscle group.

[Auricular acupuncture of magnetic pellet combined with catheter balloon dilatation in treatment of post-stroke cricopharyngeus muscle dysfunction: a randomized controlled trial].

OBJECTIVE: To observe the clinical efficacy on post-stroke cricopharyngeus muscle dysfunction treated with auricular acupuncture of magnetic pellet combined with catheter balloon dilatation, and the effect on the adverse reaction during catheter balloon dilatation and the patients' quality of life. METHODS: A total of 106 patients with post-stroke cricopharyngeus muscle dysfunction were randomly divided into an observation group (53 cases, 3 cases dropped off, 1 case excluded) and a control group (53 cases, 5 cases dropped off). The catheter balloon dilatation was provided in the control group, once a day. In the observation group, on the base of the treatment as the control group, auricular acupuncture of magnetic pellet was added. Before catheter balloon dilatation, the magnetic pellet was pressed at Yanhou (TG3), Xin (CO15), Naogan (AT3,4i), etc. These auricular points were pressed 5 min, as well as in every morning and evening for another 5 min, totally 3 times a day. The auricular acupuncture of magnetic pellet was applied on the ears alternatively each time, once every 3 days. One session treatment contained 6 days and 4 sessions of treatment were required in both groups. Before and after treatment, the scores of standardized swallowing assessment (SSA), Rosenbek penetration-aspiration scale (PAS) and swallowing quality of life (SWAL-QOL) were observed in both groups. Separately, on day 1 (T1) of treatment, in 2 weeks into treatment (T2) and on the last day of treatment (T3), the score of visual analogue scale (VAS) was recorded in both groups. The incidence of nausea and vomiting and the clinical efficacy were compared between the two groups. RESULTS: After treatment, SSA and PAS scores were reduced (P<0.05) and SWAL-QOL scores were increased (P<0.05) in both groups compared with those before treatment, and the changes in the observation group were larger than those in the control group (P<0.05). At T2 and T3, VAS scores were lower than those at T1 in both groups (P<0.05), while VAS score at each time point in the observation group was lower than that of the control group (P<0.05). The incidence of nausea and vomiting in the observation group was 51.0% (25/49), lower than the control group (79.2%, 38/48, P<0.05). The total effective rate was 95.9% (47/49) in the observation group, better than the control group (87.5%, 42/48, P<0.05). CONCLUSION: Auricular acupuncture of magnetic pellet combined with catheter balloon dilatation effectively improve the swallowing function, relieve the discomforts during the dilatation and promote the quality of life in patients with post-stroke cricopharyngeus muscle dysfunction.