{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T11:03:27Z","timestamp":1770116607216,"version":"3.49.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"15","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,4,14]]},"abstract":"\n BACKGROUND<\/jats:title>\n Posterior cranial vault distraction osteogenesis (PVDO) is a commonly used cranial expansion procedure in infants and children with syndromic craniosynostosis. To date, there have been no reports of cranial nerve (CN) palsies in patients undergoing univector PVDO.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n In this article, the authors describe the case of a 27-month-old female with Muenke syndrome who underwent long-distance (> 30 mm) PVDO and developed bilateral abducens nerve (CN VI) palsy after 40 mm of distraction. Following partial reversal of the distraction during the activation phase, the authors observed complete resolution of this palsy.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This report demonstrates that CN palsies are a potential complication for which the patient should be monitored, even when undergoing univector PVDO. Most notably, this report illustrates that a gradual reduction in the distraction distance can result in complete resolution of a CN VI palsy while also maintaining a significant degree of intracranial expansion.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24762<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24762","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T20:16:37Z","timestamp":1744661797000},"source":"Crossref","is-referenced-by-count":0,"title":["Reversible abducens nerve palsy following cranial vault expansion in the setting of multisutural craniosynostosis: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Laurie L.","family":"Ackerman","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick A.","family":"Gerety","sequence":"additional","affiliation":[{"name":"Cleft Lip & Palate Multidisciplinary Team, St. Luke\u2019s Children\u2019s Hospital, Boise, Idaho"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-0253","authenticated-orcid":true,"given":"Charline S.","family":"Boente","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn M.","family":"Haider","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Plastic & Reconstructive Surgery, Kaiser Permanente, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9630-1988","authenticated-orcid":true,"given":"Karel-Bart","family":"Celie","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma J.","family":"Cordes","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil S.","family":"Tholpady","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Plast Reconstr Surg","first-page":"1665","article-title":"Volumetric changes in cranial vault expansion: comparison of fronto-orbital advancement and posterior cranial vault distraction osteogenesis","volume":"135","author":"Derderian","year":"2015","unstructured":"Derderian CAWink JDMcGrath JLCollinsworth ABartlett SPTaylor JA.Volumetric changes in cranial vault expansion: comparison of fronto-orbital advancement and posterior cranial vault distraction osteogenesis. Plast Reconstr Surg. 2015;135(6):1665-1672."},{"issue":"5","key":"bib2","series-title":"J Craniofac Surg","first-page":"1165","article-title":"A perioperative risk comparison of posterior vault distraction osteogenesis in an older pediatric population","volume":"27","author":"Li","year":"2016","unstructured":"Li JGerety PAXu WBartlett SPTaylor JA.A perioperative risk comparison of posterior vault distraction osteogenesis in an older pediatric population. J Craniofac Surg. 2016;27(5):1165-1169."},{"issue":"4","key":"bib3","series-title":"Plast Reconstr Surg","first-page":"674e","article-title":"Perioperative morbidity in posterior cranial vault expansion: distraction osteogenesis versus conventional osteotomy","volume":"129","author":"Taylor","year":"2012","unstructured":"Taylor JADerderian CABartlett SPFiadjoe JESussman EMStricker PA.Perioperative morbidity in posterior cranial vault expansion: distraction osteogenesis versus conventional osteotomy. Plast Reconstr Surg. 2012;129(4):674e-680e."},{"issue":"2","key":"bib4","series-title":"Ann Plast Surg","first-page":"211","article-title":"Complications in posterior cranial vault distraction","volume":"76","author":"Greives","year":"2016","unstructured":"Greives MRWare BWTian AGTaylor JAPollack IFLosee JE.Complications in posterior cranial vault distraction. Ann Plast Surg. 2016;76(2):211-215."},{"issue":"2","key":"bib5","series-title":"Plast Reconstr Surg","first-page":"379","article-title":"Ten years of posterior cranial vault expansion by means of distraction osteogenesis: an update and critical evaluation","volume":"150","author":"Humphries","year":"2022","unstructured":"Humphries LSZapatero ZDVu GHTen years of posterior cranial vault expansion by means of distraction osteogenesis: an update and critical evaluation. Plast Reconstr Surg. 2022;150(2):379-391."},{"issue":"3","key":"bib6","series-title":"J Neurosurg Pediatr","first-page":"298","article-title":"Complete posterior cranial vault distraction osteogenesis to correct Chiari malformation type I associated with craniosynostosis","volume":"29","author":"Park","year":"2022","unstructured":"Park HOh SChoi JWRa YS.Complete posterior cranial vault distraction osteogenesis to correct Chiari malformation type I associated with craniosynostosis. J Neurosurg Pediatr. 2022;29(3):298-304."},{"issue":"5","key":"bib7","series-title":"Plast Reconstr Surg","first-page":"829e","article-title":"An algorithm for managing syndromic craniosynostosis using posterior vault distraction osteogenesis","volume":"137","author":"Swanson","year":"2016","unstructured":"Swanson JWSamra FBauder AMitchell BTTaylor JABartlett SP.An algorithm for managing syndromic craniosynostosis using posterior vault distraction osteogenesis. Plast Reconstr Surg. 2016;137(5):829e-841e."},{"issue":"1","key":"bib8","series-title":"J Craniofac Surg","first-page":"322","article-title":"Complications due to cranial distraction for craniosynostosis","volume":"32","author":"Noto","year":"2021","unstructured":"Noto MImai KMasuoka TSakahara DKunihiro N.Complications due to cranial distraction for craniosynostosis. J Craniofac Surg. 2021;32(1):322-324."},{"issue":"6","key":"bib9","series-title":"J Oral Biol Craniofac Res","first-page":"823","article-title":"Posterior cranial vault distraction osteogenesis: a systematic review","volume":"12","author":"Pandey","year":"2022","unstructured":"Pandey SReddy GSChug ADixit A.Posterior cranial vault distraction osteogenesis: a systematic review. J Oral Biol Craniofac Res. 2022;12(6):823-832."},{"issue":"11","key":"bib10","series-title":"Cleft Palate Craniofac J","first-page":"1925","article-title":"A rare case of sagittal sinus obstruction following posterior cranial vault distraction osteogenesis","volume":"61","author":"Hayek","year":"2024","unstructured":"Hayek GMMoon HSRadenovich VJimenez DFYates DM.A rare case of sagittal sinus obstruction following posterior cranial vault distraction osteogenesis. Cleft Palate Craniofac J. 2024;61(11):1925-1931."},{"issue":"6","key":"bib11","series-title":"Neuro-Ophthalmology","first-page":"326","article-title":"Abducens nerve palsy following expansion cranioplasty with distraction osteogenesis","volume":"38","author":"Yoo","year":"2014","unstructured":"Yoo HChung SAYoon SH.Abducens nerve palsy following expansion cranioplasty with distraction osteogenesis. Neuro-Ophthalmology. 2014;38(6):326-330."},{"issue":"11","key":"bib12","series-title":"Laryngoscope","first-page":"1285","article-title":"The microsurgical anatomy of the abducens nerve in its intracranial course","volume":"102","author":"Umansky","year":"1992","unstructured":"Umansky FValarezo AElidan J.The microsurgical anatomy of the abducens nerve in its intracranial course. Laryngoscope. 1992;102(11):1285-1292."},{"key":"bib13","series-title":"Part III: Anatomy of the Cranial Nerves","first-page":"351","article-title":"Nerves and Nerve Injuries.","author":"Baidoo","year":"2015","unstructured":"Baidoo EATubbs RSNerves and Nerve Injuries.Part III: Anatomy of the Cranial Nerves. Elsevier; 2015;351-355."},{"issue":"1","key":"bib14","series-title":"Neurology","first-page":"33","article-title":"Abducens length and vulnerability?","volume":"62","author":"Hanson","year":"2004","unstructured":"Hanson RAGhosh SGonzalez-Gomez ILevy MLGilles FH.Abducens length and vulnerability? Neurology. 2004;62(1):33-36."},{"issue":"1","key":"bib15","series-title":"Semin Neurol","first-page":"14","article-title":"Isolated palsies of cranial nerves III, IV, and VI","volume":"29","author":"Brazis","year":"2009","unstructured":"Brazis PW.Isolated palsies of cranial nerves III, IV, and VI. Semin Neurol. 2009;29(1):14-28."},{"issue":"11","key":"bib16","series-title":"Laryngoscope","first-page":"2633","article-title":"Abducens palsy after lumbar drain placement: a rare complication in endoscopic skull base surgery","volume":"123","author":"Cain","year":"2013","unstructured":"Cain RBPatel NPHoxworth JMLal D.Abducens palsy after lumbar drain placement: a rare complication in endoscopic skull base surgery. Laryngoscope. 2013;123(11):2633-2638."},{"issue":"10","key":"bib17","series-title":"J Oral Maxillofac Surg","first-page":"1197","article-title":"Bilateral abducens nerve palsy secondary to maxillofacial trauma: report of case with proposed mechanism of injury","volume":"53","author":"Lazow","year":"1995","unstructured":"Lazow SKIzzo SRFeinberg MEBerger JR.Bilateral abducens nerve palsy secondary to maxillofacial trauma: report of case with proposed mechanism of injury. J Oral Maxillofac Surg. 1995;53(10):1197-1199."},{"issue":"3","key":"bib18","series-title":"J Craniofac Surg","first-page":"664","article-title":"Experiences in performing posterior calvarial distraction","volume":"28","author":"McMillan","year":"2017","unstructured":"McMillan KLloyd MEvans MExperiences in performing posterior calvarial distraction. J Craniofac Surg. 2017;28(3):664-669."},{"issue":"6","key":"bib1","series-title":"Plast Reconstr Surg","first-page":"1665","article-title":"Volumetric changes in cranial vault expansion: comparison of fronto-orbital advancement and posterior cranial vault distraction osteogenesis","volume":"135","author":"Derderian","year":"2015","unstructured":"Derderian CAWink JDMcGrath JLCollinsworth ABartlett SPTaylor JA.Volumetric changes in cranial vault expansion: comparison of fronto-orbital advancement and posterior cranial vault distraction osteogenesis. Plast Reconstr Surg. 2015;135(6):1665-1672."},{"issue":"5","key":"bib2","series-title":"J Craniofac Surg","first-page":"1165","article-title":"A perioperative risk comparison of posterior vault distraction osteogenesis in an older pediatric population","volume":"27","author":"Li","year":"2016","unstructured":"Li JGerety PAXu WBartlett SPTaylor JA.A perioperative risk comparison of posterior vault distraction osteogenesis in an older pediatric population. J Craniofac Surg. 2016;27(5):1165-1169."},{"issue":"4","key":"bib3","series-title":"Plast Reconstr Surg","first-page":"674e","article-title":"Perioperative morbidity in posterior cranial vault expansion: distraction osteogenesis versus conventional osteotomy","volume":"129","author":"Taylor","year":"2012","unstructured":"Taylor JADerderian CABartlett SPFiadjoe JESussman EMStricker PA.Perioperative morbidity in posterior cranial vault expansion: distraction osteogenesis versus conventional osteotomy. 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Plast Reconstr Surg. 2022;150(2):379-391."},{"issue":"3","key":"bib6","series-title":"J Neurosurg Pediatr","first-page":"298","article-title":"Complete posterior cranial vault distraction osteogenesis to correct Chiari malformation type I associated with craniosynostosis","volume":"29","author":"Park","year":"2022","unstructured":"Park HOh SChoi JWRa YS.Complete posterior cranial vault distraction osteogenesis to correct Chiari malformation type I associated with craniosynostosis. J Neurosurg Pediatr. 2022;29(3):298-304."},{"issue":"5","key":"bib7","series-title":"Plast Reconstr Surg","first-page":"829e","article-title":"An algorithm for managing syndromic craniosynostosis using posterior vault distraction osteogenesis","volume":"137","author":"Swanson","year":"2016","unstructured":"Swanson JWSamra FBauder AMitchell BTTaylor JABartlett SP.An algorithm for managing syndromic craniosynostosis using posterior vault distraction osteogenesis. Plast Reconstr Surg. 2016;137(5):829e-841e."},{"issue":"1","key":"bib8","series-title":"J Craniofac Surg","first-page":"322","article-title":"Complications due to cranial distraction for craniosynostosis","volume":"32","author":"Noto","year":"2021","unstructured":"Noto MImai KMasuoka TSakahara DKunihiro N.Complications due to cranial distraction for craniosynostosis. J Craniofac Surg. 2021;32(1):322-324."},{"issue":"6","key":"bib9","series-title":"J Oral Biol Craniofac Res","first-page":"823","article-title":"Posterior cranial vault distraction osteogenesis: a systematic review","volume":"12","author":"Pandey","year":"2022","unstructured":"Pandey SReddy GSChug ADixit A.Posterior cranial vault distraction osteogenesis: a systematic review. J Oral Biol Craniofac Res. 2022;12(6):823-832."},{"issue":"11","key":"bib10","series-title":"Cleft Palate Craniofac J","first-page":"1925","article-title":"A rare case of sagittal sinus obstruction following posterior cranial vault distraction osteogenesis","volume":"61","author":"Hayek","year":"2024","unstructured":"Hayek GMMoon HSRadenovich VJimenez DFYates DM.A rare case of sagittal sinus obstruction following posterior cranial vault distraction osteogenesis. Cleft Palate Craniofac J. 2024;61(11):1925-1931."},{"issue":"6","key":"bib11","series-title":"Neuro-Ophthalmology","first-page":"326","article-title":"Abducens nerve palsy following expansion cranioplasty with distraction osteogenesis","volume":"38","author":"Yoo","year":"2014","unstructured":"Yoo HChung SAYoon SH.Abducens nerve palsy following expansion cranioplasty with distraction osteogenesis. Neuro-Ophthalmology. 2014;38(6):326-330."},{"issue":"11","key":"bib12","series-title":"Laryngoscope","first-page":"1285","article-title":"The microsurgical anatomy of the abducens nerve in its intracranial course","volume":"102","author":"Umansky","year":"1992","unstructured":"Umansky FValarezo AElidan J.The microsurgical anatomy of the abducens nerve in its intracranial course. Laryngoscope. 1992;102(11):1285-1292."},{"key":"bib13","series-title":"Part III: Anatomy of the Cranial Nerves","first-page":"351","article-title":"Nerves and Nerve Injuries.","author":"Baidoo","year":"2015","unstructured":"Baidoo EATubbs RSNerves and Nerve Injuries.Part III: Anatomy of the Cranial Nerves. Elsevier; 2015;351-355."},{"issue":"1","key":"bib14","series-title":"Neurology","first-page":"33","article-title":"Abducens length and vulnerability?","volume":"62","author":"Hanson","year":"2004","unstructured":"Hanson RAGhosh SGonzalez-Gomez ILevy MLGilles FH.Abducens length and vulnerability? Neurology. 2004;62(1):33-36."},{"issue":"1","key":"bib15","series-title":"Semin Neurol","first-page":"14","article-title":"Isolated palsies of cranial nerves III, IV, and VI","volume":"29","author":"Brazis","year":"2009","unstructured":"Brazis PW.Isolated palsies of cranial nerves III, IV, and VI. Semin Neurol. 2009;29(1):14-28."},{"issue":"11","key":"bib16","series-title":"Laryngoscope","first-page":"2633","article-title":"Abducens palsy after lumbar drain placement: a rare complication in endoscopic skull base surgery","volume":"123","author":"Cain","year":"2013","unstructured":"Cain RBPatel NPHoxworth JMLal D.Abducens palsy after lumbar drain placement: a rare complication in endoscopic skull base surgery. Laryngoscope. 2013;123(11):2633-2638."},{"issue":"10","key":"bib17","series-title":"J Oral Maxillofac Surg","first-page":"1197","article-title":"Bilateral abducens nerve palsy secondary to maxillofacial trauma: report of case with proposed mechanism of injury","volume":"53","author":"Lazow","year":"1995","unstructured":"Lazow SKIzzo SRFeinberg MEBerger JR.Bilateral abducens nerve palsy secondary to maxillofacial trauma: report of case with proposed mechanism of injury. J Oral Maxillofac Surg. 1995;53(10):1197-1199."},{"issue":"3","key":"bib18","series-title":"J Craniofac Surg","first-page":"664","article-title":"Experiences in performing posterior calvarial distraction","volume":"28","author":"McMillan","year":"2017","unstructured":"McMillan KLloyd MEvans MExperiences in performing posterior calvarial distraction. 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