S238 – Clip-fixation or Crimping? Results of 4 Stapes Prostheses

Abstract

Objectives Learn about possible differences of results by 4 different stapes prostheses. Methods In this retrospective study, all 126 contiguous patients undergoing stapes surgery for otosclerosis are included. All surgeries were performed by 2 surgeons. 4 different types of stapes prostheses were used in separate time intervals. Starting with teflon-platinum wire prosthesis, to gold piston, to titanium piston, to the self-retaining titanium Clip-piston. Results Pre- and postoperative pure tone and speech audiograms are compared. The best results were achieved by the Clip-Piston. Improvement in PTA over other pistons was 4 dB with p= 0,027 (Mann-Whitney). Bone conduction levels were better by 2 dB. In speech audiometry intellegibility was better by 3 dB with p=0,024 (Mann-Whitney). Conclusions The tight self-fixation of the Clip-Piston to the long process of the incus achieved the best results in pure tone and even more so in speech audiometry. The reason might be due to reduced slippage of the stapes prosthesis at the attachment to the incus. As other studies have shown, tight fixation of a stapes prosthesis provides the best results. The Clip-Piston achieves this by its spring action and without the danger of heat and strangulation as by other stapes pistons.