Feline head trauma: a CT analysis of skull fractures and their management in 75 cats

Knight, Rebekah; Meeson, Richard

doi:10.1177/1098612x18819183

Cited by 23 publications

(56 citation statements)

References 26 publications

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“…This lead us to believe that tympanic bulla fractures might be more frequent and sometimes undiagnosed using conventional radiology. Nevertheless, Rebekah et al performed a CT analysis of skull fractures in 75 cats and did not describe any tympanic bulla fractures ( 18 ). CT also provides additional information regarding fracture configuration and may be used to direct treatment planning ( 16 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

Traumatic Tympanic Bulla Fracture in a Cat With Severe Head Trauma

Sanroman-Llorens¹,

Whyte²,

Godinho

et al. 2020

Front. Vet. Sci.

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A nine-year-old male European shorthair cat was referred to our practice with severe head trauma after suffering a road traffic accident (RTA). The patient presented marked facial swelling and multiple skin wounds and bruising, inspiratory dyspnea, palpable mandibular and maxillary fractures, serosanguinolent oronasal discharge and right eye exophthalmos and buphthalmos with loss of menace and pupillary reflex. After stabilizing the patient, a CT scan was performed under general anesthesia and an oesophagostomy tube was placed. The scan revealed the presence of multiple right tympanic bulla fractures. Multiple mandibular, maxillary, and palatine fractures were also present. The cat underwent surgery. Mandibular symphyseal separation and maxillary fractures were stabilized using intraoral cerclage wire fixation reinforced with composite and the right eye was enucleated. The rest of the fractures were treated conservatively. A CT scan 4 months after the trauma was also performed. At this point, the maxillofacial fractures were healing properly, and a bone callus demonstrating fusion of fragments of the right tympanic bulla was evident. There was absence of abnormal content inside the right tympanic bulla. The patient recovered uneventfully with no neurological deficits. To the author's knowledge this is the first case reporting a traumatic tympanic bulla fracture in the cat with case follow up, and the first case reported using CT as diagnostic imaging test.

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Section: Discussionmentioning

confidence: 99%

Traumatic Tympanic Bulla Fracture in a Cat With Severe Head Trauma

Sanroman-Llorens¹,

Whyte²,

Godinho

et al. 2020

Front. Vet. Sci.

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“…[1][2][3][4][5][6][7][8] Feline trauma patients often sustain injuries to multiple body systems, including potentially life-threatening injuries of the thorax, abdomen and head. [3][4][5][6][9][10][11] Mortality rates for feline trauma patients presented at UK veterinary clinics have been reported to be around 12-22%. 12 Animals with head injuries frequently present with concurrent clinical injuries such as brain trauma or airway injuries, as well as shock.…”

Section: Introductionmentioning

confidence: 99%

“…9,11 The main goals of treatment of mandibular and maxillary fractures are restoration of dental occlusion and TMJ function; both are essential for feeding and grooming. 2,3,9,10,13,14…”

Section: Introductionmentioning

confidence: 99%

Feline skull injuries: Treatment goals and recommended approaches

Rizkallal

Lafuente

2020

Journal of Feline Medicine and Surgery

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Practical relevance: Skull trauma in cats, which includes fractures of the mandible and maxilla, as well as temporomandibular joint (TMJ) conditions, is frequently encountered in general practice. Clinical approach: Head trauma requires immediate attention and the initial approach should be focused on stabilisation of the patient and evaluation of the major body systems, including respiratory and cardiovascular assessment, and neurological and ophthalmic examination. The head, oral occlusion and the patient’s ability to open and close the mouth should be carefully evaluated. Once the cat is stable enough for anaesthesia, diagnostic imaging is essential to assess for skull injuries. Radiography may be helpful, although some conditions may be difficult to visualise due to soft tissue and bony structure superimposition. CT is a more sensitive technique for detecting skull injuries. Treatment goals and techniques: A variety of stabilisation techniques have been described in the feline patient, and repair goals focus on restoration of the animal’s oral function, while ensuring adequate dental occlusion, minimal invasiveness and morbidity, and pain relief. Surgical repair of mandibular and maxillary fractures may variously involve interdental wiring, interarcade wiring or suture, use of interfragmentary wires, plate and screw fixation, external skeletal fixation and use of dental acrylic. Decision-making with regard to treatment options depends on dental occlusion, type and location of the fracture, fracture stability and pain. Aim: This review, directed at general practitioners working with cats, describes the relevant anatomy of the feline skull, the most common mandibular, maxillary and TMJ conditions, and their recommended management.

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“…These stabilisation techniques have been extensively reported in the literature. 2,8,16 Regarding the use of general orthopaedic implants (stainless steel plates or external skeletal fixation) vs titanium miniplates, the stainless steel implants are widely available to surgeons that routinely perform orthopaedic surgeries. The use of these implants is well described in the surgical literature and these techniques provide adequate stability for mandibular fractures, especially comminuted fractures.…”

mentioning

confidence: 99%

“…2 This was actually the most common surgical technique used for hard palate reconstructions in a retrospective study performed in cats with skull fractures. 16 ✜ Temporomandibular joint fractures and disorders Locking-jaw syndrome in cats has been described in the literature, and reported to be over-represented in cats with brachycephalic conformation of the skull. 2 It has frequently been associated with temporomandibular joint dysplasia, but it has also been linked to traumatically induced conformational changes of the mandible and zygomatic arch 2,18,19 or even muscular pathology.…”

mentioning

confidence: 99%