The authors present two cases of unilateral abducens palsy secondary to a recent trans-sutural distraction osteogenesis (TSuDO) operation for craniosynostosis. The basic principle of the TSuDO procedure is described as dissection and distraction of the prematurely fused sutures. This complication following surgery has been rarely reported. In both cases the ocular motility deficit resolved over a two to four month period following removal of distractor. Possible mechanisms for this occurrence are discussed within the article. The authors suggest that a neuropraxic or stretch injury may have been the cause. They suggest that the two unusual cases they present may represent a combination of events following distraction osteogenesis producing shearing and / or stretching force of the abducens nerve, which reversed after removal of the distraction hardware. 

Abducens nerve palsy following expansion cranioplasty with distraction osteogenesis.
Yoo H, Chung SA, Yoon SH.
NEURO-OPHTHALMOLOGY
2014;38(6):326-30.
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Claire Howard

Salford Royal NHS Foundation Trust, Salford, UK.

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