HAZARDS OF TITANIUM MESH CRANIOPLASTY – OUR EXPERIENCE

Abstract

INTRODUCTION: Titanium is biologically inert, hard, rigid, strong, durable, light-weight, resistant to infection, easy to handle and relatively inexpensive, hence frequently used as the material of choice for cranioplasty. But at the same time there is signicant rate of complications, most commonly infection, poor cosmesis, hematoma, headache, seizure and implant exposure necessitating re-operation and implant removal. MATERIALS AND METHODS: The present study was conducted in the department of neurosurgery, Bangur Institute of Neurosciences(B.I.N), Kolkata & SSKM Hospital, IPGME & R, Kolkata from January 2019 to December 2020. The study design was non-randomized prospective observational study. The period of study was 2 years. The sample size was 30. OBSERVATIONS AND RESULTS: Total 30 patients underwent cranioplasty. Their mean age was 38 years (range, 20-62 years) with a male:female ratio of 3:2. Ten patients developed postoperative complications, making a cranioplasty complication rate of 33.34%. Out of 10 patients, 5 (50%) required further surgical procedure including 4 cases of cranioplasty removal, the overall removal rate of 13.34%. Overall mortality was nil. CONCLUSION: Titanium mesh cranioplasty though a very common procedure used for correction of craniectomy skull defect is not totally free from complication. Our present study analyse the various causative factors which may lead to complications and implant failure. We have to be very judicious in the use of materials and other modalities used for skull defect repair depending upon the current materials available, the patient's general condition, co-morbidity, their economic status and modality of surgery.