Deterioration of brachycephalic obstructive airway syndrome in a French bulldog following surgical stabilisation of atlantoaxial subluxation with concurrent atlas malformation

Abstract

AbstractA 2‐year 10‐month‐old French bulldog presented with a history of intermittent yelping episodes and low head carriage. Examination revealed cervical hyperaesthesia and grade I brachycephalic obstructive airway syndrome. Magnetic resonance imaging and computed tomography of the cervical vertebral column demonstrated a malformation of the atlas and atlantoaxial subluxation causing spinal cord compression. Ventral atlantoaxial stabilisation was performed, aided by three‐dimensional printed, patient‐specific drill guides, bicortical bone screws and polymethylmethacrylate. Four months later, the patient re‐presented being pain free but for deterioration of upper respiratory noise, distress and exercise intolerance. Grade III brachycephalic obstructive airway syndrome was evident on examination. Assessment of the post‐stabilisation computed tomography images and recent radiographs suggested that the rapid progression of brachycephalic obstructive airway syndrome had been caused by the stabilisation construct causing further narrowing of the nasopharynx by ventral and rostral displacement of the dorsocaudal nasopharyngeal wall. A folded flap palatoplasty was performed leading to excellent short‐ and long‐term outcome.