Gold and Titanium in the Oval Window: A Comparison of Two Metal Stapes Prostheses

Abstract

The objective of this study was to evaluate the hearing results of stapes surgery with 2 different full metal stapes prostheses. Retrospective analyses were carried out on the pre- and postoperative hearing results obtained after primary stapedotomy with 2 different prostheses. We studied 106 patients with otosclerosis treated by stapes surgery. Fifty-three patients had a stapedotomy with a gold piston and 53 patients received a titanium piston after stapedotomy. The results were compared according to mean audiometric parameters. Furthermore, the individual audiologic results were demonstrated with the Amsterdam Hearing Evaluations Plot (AHEP). This method is a visual presentation of the hearing result for each operated ear. These AHEPs showed that the heavier gold piston (shaft Ø 0.4 mm and weight 10192.0 microg) gives more overclosure gain (28.3%) than the lightweight (shaft Ø 0.4 mm and weight 2541.0 microg) titanium piston (9.4% cases of overclosure). Because of the different properties of the 2 pistons (gold very malleable, titanium rather stiff), a choice can be made for different anatomic or pathologic situations in the operated middle ear. The "overclosure effect" of the gold piston is higher compared with the titanium piston.