Mediterr. J. Otol 2007; 3:(1)

Implantation of 3 Different Types of Stapes Prostheses: A Retrospective Study

Stan Cotulbea, Alin Horia Marin, Stelian Lupescu, Horatiu Stefanescu, Karina Marin, and Nicolae Balica      

Otolaryngology Department, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania. cotulbea@umft.ro

OBJECTIVE: In this short-term result study, we present our experience with the various surgical techniques and prostheses that we use in stapes surgery.

MATERIALS AND METHODS:  We retrospectively analyzed the subjects’ postoperative hearing results after stapes surgery involving the implantation of 1 of 3 different types of stapedial pistons. We studied the outcomes of a total of 154 stapes operations: one hundred forty-three stapedotomies (performed with a diamond microdrill and Fisch-type manual perforators) and 11 stapedectomies. In 49 patients, a Causse-type Teflon piston with a diameter of 0.6 mm was inserted; in 45 patients, we used a Fisch-type Teflon and stainless steel piston with a diameter of 0.4 mm; and recently, in 60 patients, we used a Fisch-type titanium piston with a diameter of 0.4 mm. Pure-tone audiometry with appropriate masking was performed approximately 6 weeks postoperatively. The average postoperative air-bone gap was calculated as the postoperative air PTA minus the postoperative bone PTA.

RESULTS: Although the Fisch-type Teflon and stainless steel 0.4-mm piston provided a somewhat poorer result in the zero-to-10 dB range than did the other prostheses, that difference was not significant, and the results in the zero-to-20 dB range were comparable among the 3 types of prosthesis.

CONCLUSION: The material and shape of the prosthesis do not greatly influence the results of stapes surgery. The experience and manual skill of the surgeon remain very important factors in providing a successful outcome.  The choice of stapes prosthesis depends primarily on the preference of the surgeon.