Stapes Prosthesis Comparison

Abstract

Ninety-four consecutive stapedectomy cases using the Robinson stainless steel prosthesis are compared with 100 consecutive cases using the House stainless steel wire prosthesis. The air-bone gap was closed to within 10 dB in 94% of the cases with the Robinson prosthesis and in 88% of the cases using the House stainless steel wire prosthesis. There appeared to be no difference in the improvement at 2,000 and 4,000 cycles between the two techniques and the results were the same. Statistical study revealed there is no significant difference in the two techniques and there is no other variable. FOLLOWING Mendel Robinson's' excellent report on his results of stapes surgery using the Robinson stainless steel and Robinson Teflon stapes prostheses, one of the authors (E.L.D.) began using the Robinson prostheses routinely. It has been six years since this technique change, and the authors felt the need for a review of results. The purpose of this paper is threefold: (1) tabulation of closure results of the techniques used by two of the authors, (2) a comparison of these results and thus a comparison of the efficacy of the two techniques, and (3) a comparison of our results with the previously reported results of various techniques incI u d i n g Robin so n's.

A prospective evaluation of the Essen titanium stapes prosthesis*

“…In our study, 91% of all patients had an air–bone gap of not more than 20 dB with 60% of our patients having an air–bone gap of not more than 10 dB. Comparable studies have reported good results in 84–95% 10,12 and an ‘excellent’ result in 50–79% 10–16 . Some of these authors calculated the postoperative air–bone gap by the use of the pre‐operative bone conduction threshold and the postoperative air conduction threshold 13,15,16 .…”

“…Comparable studies have reported good results in 84-95% 10,12 and an 'excellent' result in 50-79%. [10][11][12][13][14][15][16] Some of these authors calculated the postoperative air-bone gap by the use of the pre-operative bone conduction threshold and the postoperative air conduction threshold. 13,15,16 This makes a great difference.…”

A New Crimping Device for Stapedectomy Prostheses

“…However, using wire loops, manual crimping is key and includes the risk of failure of surgery. A new self‐retaining clip prosthesis was developed by Wengen 12 to circumvent crimping. The trade‐off of this prosthesis is the relatively clumsy shape of the clip compared to the elegant classic prosthesis loop, which allows individual adaptation to anatomical variations.…”

“…The use of a self‐retaining clip prosthesis 7 as well as a self‐crimping shape memory alloy Nitinol stapes piston 8 is an alternative technique with largely unknown long‐term outcomes. Therefore, wire loop prostheses of different materials are most commonly used in stapes surgery with reliable, safe, and consistent air‐bone‐gap closure 1,9–13 . However, using a standard crimper, two problems often occur and can result in manual malcrimping as well as incus luxation.…”

Revision operations after previous stapes surgery for persisting hearing loss

“…Moreover, revision surgery is connected with higher risks, as profound sensorineual hearing loss, dizziness, etc. (3,4,5). It is generally known that the rate of successful surgical procedure, evaluated as closure of air-bone gap less than 10 dB ranges between 20-85 % (6, 7).…”