Hearing Results After Stapedotomy With a Nitinol Piston Prosthesis

Abstract

To compare the hearing results in patients with otosclerosis who underwent a stapedotomy with either a platinum wire prosthesis or a commercially available, heat-activated nitinol stapes piston prosthesis. Design: Retrospective medical chart review. Setting: Academic tertiary care medical center. Patients: Seventy-nine consecutive patients diagnosed as having otosclerosis who underwent primary stapedotomy (33 men and 46 women) were included in this study (41 ears per group). Intervention: Stapedotomy. Main Outcome Measures: The operative records of the senior surgeon (B.J.G.) were retrospectively reviewed, and hearing results were obtained. The hearing results of the patients who received a platinum wire prosthesis were compared with those who received a nitinol prosthesis. Results: Results for the platinum wire prosthesis group revealed a postoperative mean (SD) air-bone gap (ABG) of 7 (6) dB, a mean (SD) ABG closure of 21 (12) dB, and a postoperative mean (SD) speech reception threshold of 25 (16) dB. Results for the nitinol prosthesis group revealed a postoperative ABG of 8 (6) dB, an ABG closure of 25 (10) dB, and a postoperative speech reception threshold of 25 (12) dB. Conclusions: These data show that the nitinol prosthesis is equivalent to the platinum wire prosthesis in closing the ABG in patients with otosclerosis. Comparable efficacy combined with the ease and safety of heat-activated crimping supports the continued use of this prosthesis for stapes surgery.

Comparison of hearing results following the use of NiTiBOND versus Nitinol prostheses in stapes surgery: a retrospective controlled study reporting short-term postoperative results

“…We preferred the 0.6-mm diameter piston, but a successful outcome has also been reported with the application of piston diameters in the range 0.4-0.8 mm [12,13]. Some authors attribute incus necrosis to the extensive application of lasers surrounding the long process of the incus, whereas we agree with those authors who consider this phenomenon to be due to a foreign body reaction [14][15][16]. We previously demonstrated that there was no suspicion of incus necrosis in the mid-term follow-up hearing results in 44 [3].…”

Treatment of Otosclerosis with a Superelastic Nitinol Piston: First Results

“…For this purpose, a CO 2 , Argon, or KTP laser and bipolar forceps or battery-powered heating units are available. The postoperative hearing results are comparable to those achieved with a conventional prosthesis [20][21][22][23][24][25].…”

Stapedotomy and its effect on hearing – our experience with 54 cases

“…The reason for marginal male preponderance in this study is not known as the disease is known to be predominant in female [1][2][3][4][17][18][19][20][21] . Various fenestration techniques for stapes prosthesis implantation had been described 14,17,[21][22][23] . Sergi et at 22 reported the use of Laser fenestration technique and concluded that laser stapedotomy is an effective and safe procedure for the treatment of otosclerosis.…”

“…Surgery in the form of partial (stapedotomy) or complete (stapedectomy) removal of the fixed stapes and replacement with a prosthetic device (implant) has produced excellent hearing results that remain good for many years and proved to be effective in improving associated tinnitus in the affected patients [14][15][16][17][18] . This surgery that was initially described by Shea 19 had made remarkable advances in both the technique and implant materials which have contributed to improvement in surgical outcome 17,18,20 . The aims of this study were to review all the cases of otosclerosis that were managed by stapedotomy over a year period and evaluate the hearing outcome in the affected patients.…”