Horner Syndrome in Birds of Prey.

Horner syndrome, which results from oculosympathetic denervation, has rarely been reported in birds. A retrospective study was conducted in a raptor rehabilitation program to gain further insight into Horner syndrome in birds. Data from 5128 live raptors admitted over 20 years were reviewed. Horner syndrome was identified in 22 individuals from 13 different species. Raptors from the orders Strigiformes, Accipitriformes, and Falconiformes were affected, with the last order being underrepresented. Ptosis of the upper eyelid was the most commonly reported clinical sign in the birds diagnosed with Horner syndrome, having been noted in 21 cases. Signs of traumatic injury, such as fractures, wounds, and hematomas, were documented in 18 cases. Among the 22 cases, 12 birds were euthanatized, 3 died in treatment, and 7 were successfully released back into the wild.

Diagnostic approach, treatment, and outcomes of cervical sympathetic chain schwannomas: a global narrative review.

OBJECTIVE: This review examined the diagnostic approach, surgical treatment, and outcomes of cervical sympathetic chain schwannomas (CSCS) to guide clinical decision making. DATA SOURCES: Medline, EMBASE, and Cochrane databases. REVIEW METHODS: A literature review from 1998 to 2013 identified 156 articles of which 51 representing 89 CSCS cases were evaluated in detail. Demographic, clinical, and outcomes data were extracted by 2 independent reviewers with high interrater reliability (κ = .79). Cases were mostly international (82%), predominantly from Asia (50%) and Europe (27%). CONCLUSIONS: On average, patients were 42.6 years old (SD = 13.3) and had a neck mass ranging between 2 to 4 cm (52.7%) or >4 cm (43.2%). Nearly 70% of cases were asymptomatic at presentation. Presurgical diagnosis relied on CT (63.4%), MRI (59.8%), or both (19.5%), supplemented by cytology (33.7%), which was nearly always inconclusive (96.7%). US-treated cases were significantly more likely to receive presurgical MRI than internationally treated cases but less likely to have cytology (P < .05). Presurgical diagnosis was challenging, with only 11% confirmatory accuracy postsurgically. Irrespective of mass size, extracapsular resection (ie, complete resection with nerve sacrifice) was the most frequently (87.6%) performed surgical procedure. Common postsurgical adverse events included Horner's syndrome (91.1%), first bite syndrome (21.1%), or both (15.7%), with higher prevalence when mass size was >4 cm. Adverse events persisted in 82.3% of cases at an average 30.0 months (SD = 30.1) follow-up time. IMPLICATIONS FOR PRACTICE: Given the typical CSCS patient is young and asymptomatic and the likelihood of persistent morbidity is high with standard surgical approaches, less invasive treatment options warrant consideration.