A retrospective study of the hearing results obtained after stapedotomy by the implantation of two Teflon pistons with a different diameter

Abstract

Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Abstract This study reports the evaluation of hearing results after implantation of a Teflon piston of a different diameter in cases of otosclerosis requiring stapedotomy. By random selection, a Teflon piston with a shaft diameter of 0.3 mm was inserted in 34 cases and a piston with a shaft diameter of 0.4 mm in 26 cases. A retrospective analysis of the pre-and postsurgery audiological results of these two patient groups was carried out by microcomputer. A repeated statistical measures analysis of variance was used to test and estimate the air-conduction frequencyspecific differences between the two prostheses with respect to changes in pre-and postoperative healing. The results of this comparative study of the two Teflon pistons with different diameters indicate statistically a greater hearing gain for the 0.4-mm prosthesis, especially in the lower frequencies.

Stapedotomy Piston Diameter – Is Bigger Better?

“…When relating the results of the present study, the results of Grolman et al [5] and the calculations of Rosowski and Merchant [1] to the surface area of the distal part of the stapes pistons in question, it appears that a doubling in the distal surface area leads to an improvement in the air conduction thresholds of 5-7 dB. Thus, a 0.6-mm piston has the potential of improving the hearing 5-7 dB over a 0.4-mm piston, and a 0.8-mm piston has the potential of improving the hearing 5-7 dB over a 0.6-mm piston for frequencies up to and including 2 kHz.…”

“…When Fisch [4] did not find any difference between the results of 0.6-mm and 0.4-mm stapedotomy, the reason might be that he used the postoperative air bone gap as the decisive parameter. Grolman et al [5] compared the results with an all-Teflon piston with a shaft diameter of 0.3 and of 0.4 mm in randomly selected patients. They found a statistically significant difference in the gain in air conduction thresholds for frequencies between 125 Hz, 250 Hz, 500 Hz and 1 kHz.…”

Piston diameter in stapes surgery. Does it have a bearing?

“…Grolman et al, [11] compared 0.3 and 0.4 mm Teflon piston and found that 0.4 mm piston has a better postsurgical hearing result in the low frequencies. Marquet and Creten [12] reported ineffective air-bone gap closure at lower frequencies with 0.6 mm piston.…”

Stapedotomy: Functional Results with Different Diameter Prostheses

“…Similarly, Sennaroglu et al [11] , Grolman et al [12] and Marchese et al [13] when they compared the functional capacity of prostheses with 0.6-0.8, 0.3-0.4 and 0.4-0.6 mm, respectively, concluded that larger diameter prostheses led to greater improvement in hearing especially at lower frequencies. This theory could be explained by the experimental model of Rosowski and Merchant [14] , which showed that a high relationship between the prosthesis diameter and oval window surface gives the system better compliance at low frequencies.…”