Superiority of Nitinol Piston Over Conventional Prostheses in Stapes Surgery: First Comparative Results in the Chinese Population in Taiwan

Abstract

The Nitinol piston has a distinct advantage over conventional prostheses, providing an easier, safer and more effective treatment option in otosclerosis surgery. To our knowledge, this is the first comparative analysis of hearing results of the Nitinol piston with conventional prostheses in the Chinese population in Taiwan. In this population, there is a much lower prevalence of otosclerosis, leading to a lack of surgical experience in otosclerosis surgery, even at large medical centers. This may explain, in part, the relative lack of studies conducted on stapes prostheses in Asian patients. Therefore, our preliminary research may provide a reference for future investigations on stapes surgery in Asian patients with otosclerosis based on ethnic differences.

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

“…Emphasis has however been placed on post operative ABG closure of within 10dB as a measure of surgical success 26,27 . Going by this, 61.1% success as obtained from this study is comparable to findings from many previous published studies 14,20,22,24,25 .…”

“…Although 94.4% of the patients achieved some level of closure of ABG and 81.5% achieved ABG closure of ≥ 10dB from the present study, success in stapes surgery had been a subject of controversy and there had not been a consistent conclusion 20 . Emphasis has however been placed on post operative ABG closure of within 10dB as a measure of surgical success 26,27 .…”

“…Our outcome is similar to the findings of Vincent et al 24 in France who reported ABG closure of < 10dB in 63.4% and < 20 dB in 74.6% of their patients. Kuo et al 20 in Taiwan compared Nitinol prosthesis with the conventional prosthesis and reported ABG closure to within 10 dB in 75% of the patients with Nitinol piston and 33.3% in the patients with the conventional piston. Bast et al 14 reported ABG closure (< 10 dB) in 78% of their cases and Babighian et al 25 reported ABG < 10dB in 54% of their series.…”

“…Factors that influenced surgical outcome in stapes surgery had been extensively discussed 14,20,22,[28][29][30][31] . Babighian et al 25 reported that outcome of revision surgery in stapedotomy is less favourable than the primary one.…”

“…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.…”