Jeffrey P Harris1, Shusheng Gong. 1. Division of Otolaryngology-Head & Neck Surgery, University of California, San Diego 92103-8895, USA, and Union Hospital, Wuhan, China. jpharris@ucsd.edu
Abstract
OBJECTIVE: Recently, a new stapedotomy piston prosthesis, which is a composite metal alloy of nickel and titanium known as nitinol, has been introduced into medical use. This biocompatible alloy has the unique property of shape-memory, which permits tight self-crimping when heat is applied to the wire. To substantiate the favorable initial observations with the SMART piston, this study was undertaken to compare these results (n=26) with those obtained using conventional stainless steel or platinum ribbon prostheses (n=28). STUDY DESIGN: Prospective consecutive case review: consecutive cases performed by the same surgeon were analyzed. SETTING: Tertiary referral center. PATIENTS: Fifty-four healthy patients with otosclerosis. INTERVENTION: Stapedotomy using either SMART prosthesis or conventional prosthesis. MAIN OUTCOME MEASURES: Hearing outcomes by audiological assessment. RESULTS: The postoperative hearing mean pure-tone average was 24.81+/-16.20 dBHL for Group 1 (SMART prosthesis) and 27.46+/-15.57 dBHL for Group 2 (conventional prosthesis). Postoperative mean air-bone gap was 7.07+/-8.14 dBHL for Group 1 and 6.38+/-7.54 dBHL for Group 2 using 0.5-, 1-, 2-, and 4-kHz frequencies. When analyzed according to the American Academy of Otolaryngology-Head & Neck Surgery reporting criteria using an estimate of 3 kHz as a mean of the 2-and 4-kHz values, the postoperative mean air-bone gap was 5.42+/-5.4 dBHL for Group 1 SMART and 5.98+/-5.47 dBHL for Group 2 conventional prostheses. Postoperative speech discrimination scores were 96%+/-8.64% and 97%+/-5.9%, respectively. These differences were not shown to be statistically different. CONCLUSION: Results demonstrate that experienced surgeons may achieve comparable results with both prostheses; however, the ease of self-crimping and the tightness of the crimp may provide advantages that may have long-term benefits. The potential issue of nickel allergy is important when considering patients for this prosthesis.
OBJECTIVE: Recently, a new stapedotomy piston prosthesis, which is a composite metal alloy of nickel and titanium known as nitinol, has been introduced into medical use. This biocompatible alloy has the unique property of shape-memory, which permits tight self-crimping when heat is applied to the wire. To substantiate the favorable initial observations with the SMART piston, this study was undertaken to compare these results (n=26) with those obtained using conventional stainless steel or platinum ribbon prostheses (n=28). STUDY DESIGN: Prospective consecutive case review: consecutive cases performed by the same surgeon were analyzed. SETTING: Tertiary referral center. PATIENTS: Fifty-four healthy patients with otosclerosis. INTERVENTION: Stapedotomy using either SMART prosthesis or conventional prosthesis. MAIN OUTCOME MEASURES: Hearing outcomes by audiological assessment. RESULTS: The postoperative hearing mean pure-tone average was 24.81+/-16.20 dBHL for Group 1 (SMART prosthesis) and 27.46+/-15.57 dBHL for Group 2 (conventional prosthesis). Postoperative mean air-bone gap was 7.07+/-8.14 dBHL for Group 1 and 6.38+/-7.54 dBHL for Group 2 using 0.5-, 1-, 2-, and 4-kHz frequencies. When analyzed according to the American Academy of Otolaryngology-Head & Neck Surgery reporting criteria using an estimate of 3 kHz as a mean of the 2-and 4-kHz values, the postoperative mean air-bone gap was 5.42+/-5.4 dBHL for Group 1 SMART and 5.98+/-5.47 dBHL for Group 2 conventional prostheses. Postoperative speech discrimination scores were 96%+/-8.64% and 97%+/-5.9%, respectively. These differences were not shown to be statistically different. CONCLUSION: Results demonstrate that experienced surgeons may achieve comparable results with both prostheses; however, the ease of self-crimping and the tightness of the crimp may provide advantages that may have long-term benefits. The potential issue of nickelallergy is important when considering patients for this prosthesis.
Authors: Imre Gerlinger; Péter Bakó; Zalán Piski; Péter Révész; Gábor Ráth; Tamás Karosi; László Lujber Journal: Eur Arch Otorhinolaryngol Date: 2013-11-20 Impact factor: 2.503
Authors: Joachim Albert Hornung; Christoph Brase; Alessandro Bozzato; Johannes Zenk; Bernhard Schick; Heinrich Iro Journal: Eur Arch Otorhinolaryngol Date: 2010-01 Impact factor: 2.503