Calvo Ignacio, Espadas Irene, Hammond Gawain, Pratschke Kathryn
Small Animal Hospital - Division of Small Animal Sciences, School of Veterinary Medicine, University of Glasgow.
J S Afr Vet Assoc. 2014 Aug 22;85(1):1050. doi: 10.4102/jsava.v85i1.1050.
A 7-year-old male entire West Highland white terrier was referred to the Small Animal Hospital at the University of Glasgow for bilateral, chronic, medically unresponsive otitis media and externa. A history of cranio-mandibular osteopathy was also reported. Bilateral total ear canal ablation and lateral bulla osteotomy was performed with the aid of a pneumatic burr. Extensive bone proliferation was present bilaterally originating from the caudal mandibular ramus and tympanic bulla which incorporated the horizontal canal on each side. The right facial nerve was identified leaving the stylomastoid foramen and running in a cranial direction through a 1.5 cm diameter cuff of bone surrounding the horizontal canal and external acoustic meatus. Despite careful dissection, a facial nerve neurotmesis ensued which required microsurgical epineurial repair. Neurologic examination performed 12 h post-operatively revealed abnormalities consistent with right facial nerve paralysis. At 3 months, the facial nerve function was found to have improved significantly and was assessed to be normal four months after surgery. To the authors' knowledge, this clinical communication described the first reported clinical case where unilateral facial nerve paralysis resulting from iatrogenic facial nerve neurotmesis was successfully treated by microsurgical epineurial repair.
一只7岁的雄性未绝育西部高地白梗犬被转诊至格拉斯哥大学小动物医院，患有双侧慢性、药物治疗无效的中耳炎和外耳炎。据报告，该犬还有颅下颌骨病病史。借助气动钻进行了双侧全耳道切除术和外侧鼓泡切开术。双侧均存在广泛的骨增生，起自下颌骨后支和鼓泡，累及每侧的水平半规管。右侧面神经从茎乳孔穿出，沿颅侧方向走行，穿过围绕水平半规管和外耳道的直径1.5厘米的骨环。尽管进行了仔细的解剖，但仍发生了面神经断伤，需要进行显微外科神经外膜修复。术后12小时进行的神经学检查显示出与右侧面神经麻痹相符的异常情况。3个月时，发现面神经功能有显著改善，术后4个月评估为正常。据作者所知，本临床报告描述了首例因医源性面神经断伤导致单侧面神经麻痹并通过显微外科神经外膜修复成功治疗的临床病例。
