Tapia syndrome is known as a rare complication of airway manipulation, which can occur after any type of surgery under endotracheal general anesthesia. This syndrome is characterized by neurologic deficits involving the hypoglossal (XII) and recurrent laryngeal branch of the vagal nerve (X) that result in the tongue muscle's unilateral paralysis associated with the vocal cord's unilateral palsy. This article describes the first case of Tapia syndrome, which occurred after repair of a fractured zygomatic complex. In this article, we discuss the diagnosis, possible causes, clinical manifestations, treatment methods, and preventive strategies as described in 10 case reports in the literature that have been attributed to manipulation of the airway. (C) 2013 American Association of Oral and Maxillofacial Surgeons