Ackerman Laurie L, Gerety Patrick A, Boente Charline S, Haider Kathryn M, Chu Michael W, Celie Karel-Bart, Cordes Emma J, Tholpady Sunil S
Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana.
Cleft Lip & Palate Multidisciplinary Team, St. Luke's Children's Hospital, Boise, Idaho.
J Neurosurg Case Lessons. 2025 Apr 14;9(15). doi: 10.3171/CASE24762.
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.
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.
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. https://thejns.org/doi/10.3171/CASE24762.
后颅穹窿牵张成骨术（PVDO）是患有综合征性颅缝早闭症的婴幼儿常用的颅骨扩张手术。迄今为止，尚无关于接受单向PVDO手术的患者出现脑神经（CN）麻痹的报道。
在本文中，作者描述了一名27个月大患有蒙克综合征的女性病例，该患者接受了远距离（>30毫米）PVDO手术，在牵引40毫米后出现双侧展神经（CN VI）麻痹。在激活阶段对牵引进行部分逆转后，作者观察到这种麻痹完全消失。
本报告表明，即使是接受单向PVDO手术，脑神经麻痹也是一种需要对患者进行监测的潜在并发症。最值得注意的是，本报告表明，逐渐减小牵引距离可导致CN VI麻痹完全消失，同时还能保持显著程度的颅内扩张。https://thejns.org/doi/10.3171/CASE24762 。
