Even titanium is not that inert
Reviewed by Hassan Mohammed

Titanium is part of most implantable metals in the human body including cochlear implants (CIs). Allergy to titanium is rare. The authors hypothesised that such an allergy could be a cause of pain in CI patients. They present a case report of 2 patients who were diagnosed and treated for titanium allergy. The first patient had a history of contact dermatitis when she was using her hearing aids. She started having issues with episodic swelling and skin weeping after the implant with no apparent infection or extrusion. The authors obtained allergy tests for the patient and they found a strong allergic reaction to titanium. The second patient had her implant, then started complaining of discomfort afterwards with crusting and erythema at the implant site. She was found to be allergic to titanium as well. In this patient, the pain persisted after explanting. Authors concluded that allergy to titanium is a rare cause of pain and discomfort in CI patients. Especially in absence of overt signs of infection. While not applicable in every patient, titanium allergy is a cause worth considering in patients presenting with chronic pain following implantation.

Titanium Allergy: An Uncommon Cause of Pain in Cochlear Implant Recipients.
Hong A, Lucas J.
OTOL NEUROTOL
2026;47(3):e522–4.