Removal of symptomatic craniofacial titanium hardware following craniotomy: Case series and review

Sheri K. Palejwala, Jesse Skoch, G. Michael Lemole

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Titanium craniofacial hardware has become commonplace for reconstruction and bone flap fixation following craniotomy. Complications of titanium hardware include palpability, visibility, infection, exposure, pain, and hardware malfunction, which can necessitate hardware removal. We describe three patients who underwent craniofacial reconstruction following craniotomies for trauma with post-operative courses complicated by medically intractable facial pain. All three patients subsequently underwent removal of the symptomatic craniofacial titanium hardware and experienced rapid resolution of their painful parasthesias. Symptomatic plates were found in the region of the frontozygomatic suture or MacCarty keyhole, or in close proximity with the supraorbital nerve. Titanium plates, though relatively safe and low profile, can cause local nerve irritation or neuropathy. Surgeons should be cognizant of the potential complications of titanium craniofacial hardware and locations that are at higher risk for becoming symptomatic necessitating a second surgery for removal.

Original languageEnglish (US)
Pages (from-to)115-119
Number of pages5
JournalInterdisciplinary Neurosurgery: Advanced Techniques and Case Management
Issue number2
StatePublished - Jun 2015
Externally publishedYes


  • Cranial fixation
  • Craniofacial trauma
  • Hardware removal
  • Orbitozygomatic craniotomy
  • Supraorbital nerve
  • Titanium plate

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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