Gupta Raghav, Adeeb Nimer, Griessenauer Christoph J, Moore Justin M, Patel Apar S, Thomas Ajith J, Ogilvy Christopher S
Department of Surgery, Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Acta Neurochir (Wien). 2016 Oct;158(10):1845-8. doi: 10.1007/s00701-016-2929-7. Epub 2016 Aug 12.
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.
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.
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.
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.
钛固定板常用于开颅术后骨瓣的坚固固定。在颅面外科手术或涉及眶颧截骨术的开颅术后，由于感染、疼痛、突出、软组织侵蚀和钢板故障，这些钢板偶尔会被取出。然而，在没有眶颧截骨术的开颅术后因疼痛和突出而取出钢板的情况鲜有报道。
对2014年至2016年期间在一家机构由资深作者进行开颅术后颅骨固定板取出术的所有患者进行回顾性分析。
2014年至2016年期间，共有319例患者在开颅术后使用颅骨固定板进行骨瓣固定。其中5例患者（1.6%）因疼痛和突出而取出颅骨钢板。在此期间，另有4例患者在2014年之前进行初次开颅手术时取出了颅骨固定板。所有9例患者在取出钢板后症状立即缓解。
我们报告了在没有眶颧截骨术的开颅手术患者中，特别是额颞开颅术后，因疼痛和突出而取出颅骨固定板的经验。为了减少这种并发症，我们最近停止在额颞开颅术的锁孔区域钻一个全尺寸的骨孔，从而不再需要钛制骨孔盖板。
