Comparison of Fluoroplastic Causse Loop Piston and Titanium Soft-Clip in Stapedotomy

Document Type : Original

Authors

Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Introduction:
Different types of prosthesis are available for stapes replacement. Because there has been no published report on the efficacy of the titanium soft-clip vs the fluoroplastic Causse loop Teflon piston, we compared short-term hearing results of both types of prosthesis in patients who underwent stapedotomy due to otosclerosis.
Materials and Methods:
A total of 57 ears were included in the soft-clip group and 63 ears were included in the Teflon-piston group. Pre-operative and post-operative air conduction, bone conduction, air-bone gaps, speech discrimination score, and speech reception thresholds were analyzed.
Results:
Post-operative speech reception threshold gains did not differ significantly between the two groups (P=0.919). However, better post-operative air-bone gap improvement at low frequencies was observed in the Teflon-piston group over the short-term follow-up (at frequencies of 0.25 and 0.50 kHz; P=0.007 and P=0.001, respectively).
Conclusion:
Similar post-operative hearing results were observed in the two groups in the short-term.

Keywords

Main Subjects


1. Hausler R. General history of stapedectomy. Adv Otorhinolaryngol. 2007;65:1–5.
2. Shea JJ, Jr. Fenestration of the oval window. Ann Otol Rhinol Laryngol. 1958;67(4):932–51.
3. Fritsch MH, Naumann IC. Phylogeny of the stapes prosthesis. Otol Neurotol. 2008; 29(3):       407–15.
4. Massey BL, Kennedy RJ, Shelton C. Stapedectomy outcomes: titanium versus Teflon wire prosthesis. Laryngoscope. 2005; 115(2):       249-52.
5. Brown KD, Gantz BJ. Hearing results after stapedotomy with a nitinol piston prosthesis. Arch Otolaryngol Head Neck Surg. 2007; 133(8):758-62.
6. Huber AM, Ma F, Felix H, Linder T. Stapes prosthesis attachment: the effect of crimping on sound transfer in otosclerosis surgery. Laryngoscope. 2003; 113(5):853–8.
7. Mangham CA, Jr. Nitinol-Teflon stapes prosthesis improves low-frequency hearing results after stapedotomy. Otol Neurotol. 2010; 31(7): 1022-6.
8. Fayad JN, Semaan MT, Meier JC, House JW. Hearing results using the SMart piston prosthesis. Otol Neurotol. 2009; 30(8):1122–7.
9. Van Rompaey V, Yung M, Claes J, Hausler R, Martin C, Somers T, et al. Prospective effectiveness of stapes surgery for otosclerosis in a multicenter audit setting: feasibility of the Common Otology Database as a benchmark database. Otol Neurotol. 2009; 30(8):1101–10.
10. Mangham CA, Jr. Titanium CliP piston versus platinum-ribbon Teflon piston: piston and fenestra size affect air-bone gap. Otol Neurotol. 2008; 29(1):8–12.
11. Schrotzlmair F, Suchan F, Kisser U, Hempel JM, Sroka R, Muller J. Promising clinical results of an innovative self-crimping stapes prosthesis in otosclerosis surgery. Otol Neurotol. 2013; 34(9): 1571–5.
12. Ying YL, Hillman TA, Chen DA. Patterns of failure in heat-activated crimping prosthesis in stapedotomy. Otol Neurotol. 2011; 32(1):21–8.
13. Huber AM, Veraguth D, Schmid S, Roth T, Eiber A. Tight stapes prosthesis fixation leads to better functional results in otosclerosis surgery. Otol Neurotol. 2008; 29(7):893–9.
14. Tange RA, Grolman W. An analysis of the air-bone gap closure obtained by a crimping and a non-crimping titanium stapes prosthesis in otosclerosis. Auris Nasus Larynx. 2008; 35(2):181–4.
15. Zepeda-Lopez EG, Bello-Mora A, Felix-Trujillo MM. Poststapedectomy hearing gain: comparison of a Teflon (fluoroplastic ASTM F 754) prosthesis with a Schuknecht-type wire/Teflon prosthesis. Ear Nose Throat J. 2005; 84(11):707–8,10,19.
16. Ueda H, Kishimoto M, Uchida Y, Sone M. Factors affecting fenestration of the footplate in stapes surgery: effectiveness of Fisch's reversal steps stapedotomy. Otol Neurotol. 2013; 34(9): 1576–80.
17. Skinner M, Honrado C, Prasad M, Kent HN, Selesnick SH. The incudostapedial joint angle: implications for stapes surgery prosthesis selection and crimping. Laryngoscope. 2003; 113(4):647–53.
18. Brar T, Passey JC, Agarwal AK. Comparison of hearing outcome using a Nitinol versus Teflon prosthesis in stapedotomy. Acta Otolaryngol. 2012; 132(11):1151–4.
19. Sorom AJ, Driscoll CL, Beatty CW, Lundy L. Retrospective analysis of outcomes after stapedotomy with implantation of a self-crimping Nitinol stapes prosthesis. Otolaryngol Head Neck Surg. 2007; 137(1):65–9.