Our Experience with the Titanium Soft Clip Piston Stapedotomy

Abstract

The crimping of stapes prosthesis to the long process of incus has always been the bugbear of an otologist. Malcrimping on one hand can lead to necrosis of the long process on the other it can lead to a residual air-bone gap or a postoperative reappearance of the conductive hearing loss. To solve these problems different types of stapes prostheses having different techniques to achieve a secure attachment to incus have been devised. Retrospective analysis of patient data. Tertiary care hospital. Case records of 20 patients of otosclerosis who had undergone stapedotomy using titanium soft clip stapes piston (Kurz, Germany) were retrospectively analysed. This new type of stapes piston is a modification of the earlier àWengen clip piston (Kurz, Germany) which was designed to avoid the crimping onto the incus in stapedotomy. Hearing results were analyzed using American Academy of Otolaryngology-Head and Neck Surgery guidelines including 4 frequency pure tone average. The mean postoperative air-bone gap was with in 10dB in 8 (40% of cases), up to 15dB in another 8 (40%) cases and in rest 4 (20%) was with in 20dB. No adverse reactions occurred during follow-up. The use of the titanium soft clip stapes piston gives good results in cases of stapedotomy for otosclerosis. The soft clip design is a new development in the evolution of stapes piston prostheses. Surgical introduction, placement, and fixation are easier than the earlier àWengen design of clip piston.