Rizkallal Cristina, Lafuente Pilar
Department of Animal Medicine and Surgery, Universidad CEU Cardenal Herrera, C/Ramón y Cajal s/n, Alfara del Patriarca, 46115 Valencia, Spain.
J Feline Med Surg. 2020 Mar;22(3):229-240. doi: 10.1177/1098612X20903602.
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.
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.
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.
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.
猫的颅骨创伤，包括下颌骨和上颌骨骨折以及颞下颌关节（TMJ）疾病，在普通临床实践中经常遇到。
头部创伤需要立即关注，初始方法应集中在患者的稳定以及主要身体系统的评估上，包括呼吸和心血管评估以及神经和眼科检查。应仔细评估头部、口腔咬合以及猫张嘴和闭嘴的能力。一旦猫稳定到足以进行麻醉，诊断成像对于评估颅骨损伤至关重要。放射ography可能会有所帮助，尽管由于软组织和骨骼结构的重叠，一些情况可能难以看清。CT是检测颅骨损伤更敏感的技术。
在猫科动物患者中已经描述了多种稳定技术，修复目标集中在恢复动物的口腔功能，同时确保足够的牙齿咬合、最小的侵入性和发病率以及缓解疼痛。下颌骨和上颌骨骨折的手术修复可能分别涉及牙间结扎、牙弓间结扎或缝合、使用骨间钢丝、钢板和螺钉固定、外骨骼固定以及使用牙科丙烯酸。关于治疗选择的决策取决于牙齿咬合、骨折的类型和位置、骨折稳定性和疼痛。
这篇针对治疗猫的全科医生的综述描述了猫科动物颅骨的相关解剖结构、最常见的下颌骨、上颌骨和颞下颌关节疾病及其推荐的管理方法。
