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Journal of Comparative Pathology Apr 2020Brachycephalic dog breeds have experienced a marked rise in popularity in recent years. While numerous people clearly desire this phenotype in their pets, many of these... (Review)
Review
Brachycephalic dog breeds have experienced a marked rise in popularity in recent years. While numerous people clearly desire this phenotype in their pets, many of these dogs unfortunately experience several concomitant sequelae, including major problems with respiration and thermoregulation, as well as gastrointestinal, ophthalmological, dermatological, reproductive and even dental problems. This mini review focuses on the anatomical and pathological changes associated with brachycephalic skull shape, including brachycephalic obstructive airway syndrome and other co-existent disorders. It then details the known genetic contributors to brachycephaly, and concludes with a brief discourse on the welfare of these animals.
Topics: Animals; Craniosynostoses; Dog Diseases; Dogs
PubMed: 32359622
DOI: 10.1016/j.jcpa.2020.02.008 -
Bosnian Journal of Basic Medical... May 2018Craniosynostosis is a developmental craniofacial anomaly, resulting in impairment of brain development and abnormally shaped skull. The main cause of craniosynostosis is... (Review)
Review
Craniosynostosis is a developmental craniofacial anomaly, resulting in impairment of brain development and abnormally shaped skull. The main cause of craniosynostosis is premature closure of one or more cranial sutures. It usually occurs as an isolated condition, but may also be associated with other malformations as part of complex syndromes. When left untreated, craniosynostosis can cause serious complications, such as developmental delay, facial abnormality, sensory, respiratory and neurological dysfunction, anomalies affecting the eye, and psychological disturbances. Thus, early diagnosis, expert surgical techniques, postoperative care, and adequate follow-up are of vital importance in treating craniosynostosis.
Topics: Brain; Cranial Sutures; Craniosynostoses; Developmental Disabilities; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Prevalence; Skull
PubMed: 28623672
DOI: 10.17305/bjbms.2017.2083 -
Pediatric Annals Oct 2020The Safe to Sleep campaign started in 1994, reducing the risk of sudden infant death syndrome (SIDS) by 40% to 60%. However, an undesirable consequence has been a 400%... (Review)
Review
The Safe to Sleep campaign started in 1994, reducing the risk of sudden infant death syndrome (SIDS) by 40% to 60%. However, an undesirable consequence has been a 400% to 600% increase in positional head deformities. We review the risks for positional plagiocephaly or brachycephaly, treatment modalities, and when to refer. Differential diagnoses for non-positional deformities are discussed. Risks for positional head deformities include prenatal, perinatal and postnatal factors. These include torticollis, inadequate tummy time, abnormal intrauterine positioning, premature or postmature birth, prolonged labor, complex medical conditions, prolonged hospitalizations, developmental delay, and use of supportive or convenience devices. Recommended treatment involves repositioning techniques or physical therapy with or without helmet use. Early referral to physical therapy or a head shape program insures better outcomes for full correction of the deformity. The severity of residual deformities is directly related to the age at which the child is referred. [Pediatr Ann. 2020;49(10):e440-e447.].
Topics: Craniosynostoses; Humans; Infant; Physical Therapy Modalities; Plagiocephaly, Nonsynostotic; Sleep
PubMed: 33034660
DOI: 10.3928/19382359-20200922-02 -
Pediatric Annals Jan 2023Along with the decrease in sudden infant death syndrome due to the successful "Back to Sleep" Campaign, there was a reciprocal increase in cases of positional... (Review)
Review
Along with the decrease in sudden infant death syndrome due to the successful "Back to Sleep" Campaign, there was a reciprocal increase in cases of positional plagiocephaly (PP). The prevalence of PP significantly rose from approximately 5% to upward of 46% at age 7 months. Consequently, clinicians have seen a surge in the number of patients presenting with head shape abnormalities. Not only does this increase in patient volume pose a logistical problem to clinics, but it also poses a potential risk to patients with craniosynostosis, whose head shape anomalies are similar to a "needle in a haystack" of patients with more common PP. This review explores the causes, risk factors, and treatment options of PP and craniosynostosis, along with the differential of head shape anomalies based on phenotypic presentation. In doing so, we hope to provide pediatric care clinicians with the tools necessary to effectively evaluate and manage patients with head shape abnormalities. .
Topics: Infant; Child; Humans; Plagiocephaly, Nonsynostotic; Craniosynostoses; Risk Factors; Sleep; Prevalence
PubMed: 36625797
DOI: 10.3928/19382359-20221114-03 -
Brain Structure & Function Dec 2023The shape of the cranium is one of the most notable physical changes induced in domestic dogs through selective breeding and is measured using the cephalic index (CI)....
The shape of the cranium is one of the most notable physical changes induced in domestic dogs through selective breeding and is measured using the cephalic index (CI). High CI (a ratio of skull width to skull length > 60) is characterized by a short muzzle and flat face and is referred to as brachycephaly. Brachycephalic dogs display some potentially harmful changes in neuroanatomy, and there are implications for differences in behavior, as well. The path from anatomy to cognition, however, has not been charted in its entirety. Here, we report that sleep-physiological markers of white-matter loss (high delta power, low frontal spindle frequency, i.e., spindle waves/s), along with a spectral profile for REM (low beta, high delta) associated with low intelligence in humans, are each linked to higher CI values in the dog. Additionally, brachycephalic subjects spent more time sleeping, suggesting that the sleep apnea these breeds usually suffer from increases daytime sleepiness. Within sleep, more time was spent in the REM sleep stage than in non-REM, while REM duration was correlated positively with the number of REM episodes across dogs. It is currently not clear if the patterns of sleep and sleep-stage duration are mainly caused by sleep-impairing troubles in breathing and thermoregulation, present a juvenile-like sleeping profile, or are caused by neuro-psychological conditions secondary to the effects of brachycephaly, e.g., frequent REM episodes are known to appear in human patients with depression. While future studies should more directly address the interplay of anatomy, physiology, and behavior within a single experiment, this represents the first description of how the dynamics of the canine brain covary with CI, as measured in resting companion dogs using a non-invasive sleep EEG methodology. The observations suggest that the neuroanatomical changes accompanying brachycephaly alter neural systems in a way that can be captured in the sleep EEG, thus supporting the utility of the latter in the study of canine brain health and function.
Topics: Dogs; Humans; Animals; Sleep; Sleep, REM; Electroencephalography; Brain; Craniosynostoses
PubMed: 37742302
DOI: 10.1007/s00429-023-02706-y -
Child's Nervous System : ChNS :... Sep 2012Non-syndromic coronal synostoses oxycephaly and brachycephaly (NSCSOB) are rare. Their natural history, surgical management, and outcome are debated. (Review)
Review
BACKGROUND
Non-syndromic coronal synostoses oxycephaly and brachycephaly (NSCSOB) are rare. Their natural history, surgical management, and outcome are debated.
MATERIAL AND METHODS
We reviewed the available literature on NSCSOB. In addition, we reviewed retrospectively our experience with cases of NSCSOB, managed and operated by our joint craniofacial team since 1984. Newborns underwent perifrontal craniectomy, while infants and older children underwent fronto-orbital advancement with frontoparietal remodeling. Cases with delayed onset of faciosynostosis were excluded.
RESULTS
Some cases of NSCSOB present at birth or even prenatally with gross dysmorphism and severe brachycephaly; others present later in life with harmonious restriction of intracranial volume and are at risk for development and vision. Some NSCSOB evolve from initially unisutural synostoses. We treated 61 cases, operated aged 1.4 to 106.7 months, 30 with brachycephaly and 31 with oxycephaly. Twelve of these (19.7 %), had been treated initially for sagittal or unicoronal synostosis, and evolved into NSCSOB. Intracranial hypertension was present initially in 28 (45.9 %), with ophthalmological consequences in 13 (21.3 %) and mental retardation in 6 (9.6 %). No patient had hydrocephalus; only two had asymptomatic Chiari malformation. The mean postoperative follow-up was 113.6 months. At last control, 21 patients had developmental delay and 5 had visual impairment.
CONCLUSIONS
NSCSOB are a complex entity. They have in common a high risk of severe intracranial hypertension and rare hydrodynamic complications. Genetic screening is necessary to assert their non-syndromic nature. Prolonged follow-up of all craniosynostoses is necessary because unisutural synostoses can evolve into NSCSOB, and NSCSOB can evolve into craniofaciosynostosis.
Topics: Craniosynostoses; Humans; Plastic Surgery Procedures; Treatment Outcome
PubMed: 22872261
DOI: 10.1007/s00381-012-1800-2 -
Veterinary Dermatology Jun 2022Brachycephalic dog breeds have multiple skull malformations which may lead to anatomical changes in the external auditory canal. It is our frequent observation that in...
BACKGROUND
Brachycephalic dog breeds have multiple skull malformations which may lead to anatomical changes in the external auditory canal. It is our frequent observation that in the otoscopic examination of the external ear in these breeds we are unable to visualise the tympanic membrane as a consequence of extreme narrowing of the proximal ear canal. Additionally brachycephalic dogs reportedly are predisposed to otitis externa (OE) and otitis media.
OBJECTIVES
To characterizse the transition of the cartilaginous ear canal to the bony meatus acusticus externus using computed tomography (CT) and to investigate a possible association with OE in brachycephalic dogs.
MATERIALS AND METHODS
Seventy-five client-owned dogs [pugs (n = 20), French bulldogs (n = 55)] were included and assessed for OE using an owner questionnaire and otoscopic and cytological examinations. In dorsal plane CT scans, the diameter of the porus acusticus externus was measured using novel methodology. The results were compared with a normocephalic control group without preexisting otological disorders.
RESULTS
Brachycephalic dogs had a significantly smaller porus acusticus externus diameter (2.6 mm) than normocephalic dogs (5.0 mm). Of the brachycephalic dogs, 32% had OE yet this was not statistically significantly related to the diameter of the porus acusticus externus. Middle ear effusion (44%) and narrowing of the external ear canal (82.6%) were significantly more frequent in brachycephalic dogs. Only five of 150 eardrums could be visualised otoscopically.
CONCLUSIONS AND CLINICAL RELEVANCE
Malformation of the porus acusticus externus causes severe stenosis of the proximal ear canal in brachycephalic dogs. A connection between stenosis of the external auditory canal and OE could not be confirmed.
Topics: Animals; Constriction, Pathologic; Craniosynostoses; Dog Diseases; Dogs; Ear Canal; Otitis Externa
PubMed: 35293639
DOI: 10.1111/vde.13067 -
Ryoikibetsu Shokogun Shirizu 2000
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Neuro-Chirurgie Nov 2019
Topics: Child; Craniosynostoses; Humans
PubMed: 31699291
DOI: 10.1016/j.neuchi.2019.10.001 -
The Veterinary Quarterly Dec 2022Brachycephalic obstructive airway syndrome (BOAS) is a chronic, lifelong, debilitating, primarily obstructive airway disease which adversely affects the quality of life... (Review)
Review
Brachycephalic obstructive airway syndrome (BOAS) is a chronic, lifelong, debilitating, primarily obstructive airway disease which adversely affects the quality of life of many popular dog breeds. Respiratory restriction in bulldog breeds, pugs and Boston terriers frequently co-exist with pathologies of the gastrointestinal tract. In addition, many brachycephalic dogs that appear clinically normal are, in fact suffering from chronic hypoxia and its systemic consequences. Concurrent gastroesophageal reflux-associated conditions, sleep disorders and systemic hypertension further impact the welfare of affected dogs. Acceptance of BOAS and associated clinical signs as being 'normal for the breed' is common amongst owners. While surgical correction of the upper airway is the mainstay of treatment, the provision of subsequent, frequently lifelong medical management is equally important for the maintenance of an acceptable quality of life, at least for some affected patients. Here we review the current knowledge concerning brachycephaly, combine it with shared clinical experience in the management of this debilitating condition, and discuss ethical considerations and the responsibility of veterinarians to contribute public education and to support appropriate breed standards for animals under our care.
Topics: Dogs; Animals; Quality of Life; Dog Diseases; Craniosynostoses; Airway Obstruction
PubMed: 36342210
DOI: 10.1080/01652176.2022.2145621