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01-10-2016 | Technical Note - Neurosurgical Techniques

Removal of symptomatic titanium fixation plates after craniotomy

Authors: Raghav Gupta, Nimer Adeeb, Christoph J. Griessenauer, Justin M. Moore, Apar S. Patel, Ajith J. Thomas, Christopher S. Ogilvy

Published in: Acta Neurochirurgica | Issue 10/2016

Abstract

Introduction

Titanium fixation plates are routinely used for rigid fixation of bone flaps after craniotomy. In craniofacial surgery or after craniotomy involving orbitozygomatic osteotomies, these plates are occasionally removed because of infection, pain, protrusion, soft tissue erosion, and plate malfunction. However, plate removal because of pain and protrusion after craniotomy without orbitozygomatic osteotomy has rarely been reported.

Methods

A retrospective analysis of all patients who underwent removal of cranial fixation plates after craniotomy, performed by the senior authors at one institution between 2014 and 2016, was conducted.

Results

A total of 319 patients underwent bone flap fixation after craniotomy using cranial fixation plates between 2014 and 2016. Five of those patients (1.6 %) had their cranial plates removed because of pain and protrusion. An additional four patients had a cranial fixation plate removed during that time frame with the original craniotomy performed before 2014. All nine patients had immediate resolution of symptoms after plate removal.

Conclusion

We report our experience with cranial fixation plate removal because of pain and protrusion in patients who underwent craniotomy without orbitozygomatic osteotomy, particularly frontotemporal craniotomy. In an attempt to reduce this complication, we recently stopped placing a full-size burr hole in the keyhole area of a frontotemporal craniotomy, eliminating the need for a titanium burr hole cover plate.

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Title: Removal of symptomatic titanium fixation plates after craniotomy
Authors: Raghav Gupta
Nimer Adeeb
Christoph J. Griessenauer
Justin M. Moore
Apar S. Patel
Ajith J. Thomas
Christopher S. Ogilvy
Publication date: 01-10-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 10/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2929-7

At a glance: The STEP trials

Springer Medicine

Removal of symptomatic titanium fixation plates after craniotomy

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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