Case Report & Case SeriesExposure of titanium implants after cranioplasty: A matter of long-term consequences

•The use of titanium implants in cranioplasty are sometimes difficult to long-term manage.•Records of eight patients with exposure of titanium implants were reviewed.•Especially in cases with postoperative surgical site infections in female patients, long-term follow up is necessary.

Although the use of titanium implants in cranioplasty has recently become common, long-term results of this strategy are sometimes difficult to manage. The aim of this study was to clarify the characteristics of patients developing exposure of titanium implants. Records of eight patients with exposure of titanium implants were reviewed. Patient ages ranged from 41 to 77 (mean, 56.8) years. Two patients were male, and six were female. The periods from implantation to exposure of titanium implants ranged from 5 to 87 (mean, 30.5) months. In seven cases, titanium mesh cranioplasty was performed after postcraniotomy infections. The titanium implants were removed in all cases. Scalp tissue was closed by applying a primary closure technique in five cases, though scalp reconstruction was performed with a rotation flap in the other three cases involving large scalp ulceration. Although the use of titanium implants is convenient, the indications should be carefully considered, especially in cases with postoperative surgical site infections and in patients with thin scalp skin. For these patients, long-term follow up is necessary.

Graphical abstractDownload high-res image (203KB)Download full-size image