Stapedotomy with titanium and Teflon prostheses: Retrospective analysis of the results

Estapedotomía con prótesis de titanio y teflón: Análisis retrospectivo de los resultados

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Luis Fernando Rincón Renza

Abstract

Objective: to describe the results obtained with the placement of two stapedial prostheses to patients subjected to stapedotomy due to otosclerosis. Type of study: descriptive and retrospective review of cases.
Methods: titanium and Teflon-platinum prostheses were used to close the difference between the bone and air (gap) curves produced by otosclerosis. We reviewed 70 cases intervened at the Hospital de San José between 2002 and 2005, by three surgeons. We used a small fenestration technique performed with manual drillers; 48 cases met the criteria. We excluded cases of revision, those with anatomical anomalies or inadequate data before or after surgery. The bone-air gap was measured with pure tone audiometry at four frequencies and the limit threshold for sensorineural hearing loss, based on the PTA (auditory tonal average).
Results: 33 cases were grouped with Teflon and 15 titanium prostheses. The closure of the bone-air gap less than or equal to 10 db was 80% for titanium and 76% for Teflon. The sensorineural hearing loss was low for both groups without significant difference.
Discussion: the results were similar for both groups, but it was observed that the titanium prosthesis was slightly higher. The results described agree with those reported in the literature, which show a range in the closure of the bone-air gap less than 10 db from 71% to 94%. The small number of cases or the predilection for one of the prostheses can influence the result described.
Abbreviations: PTA, auditory tonal average; db, decibel; gap, difference between bone and air curves.

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References

1. Slattery WH 3rd, House JW. Prostheses for stapes surgery. Otolaryngol Clin North Am. 1995 Apr;28(2):253-64.

2. Zuur CL, de BruijnAJ, Lindeboom R, Tange RA. Retrospective analysis of early postoperative hearing results obtained alter stapedotomy with implantation of a new titanium stapes prosthesis. Otol Neurotol. 2003 Nov;24(6):863-7.

3. Massey BL, Kennedy RJ, Shelton C. Stapedectomy outcomes: titanium versus teflon wire prosthesis. Laryngoscope. 2005 Feb;115(2):249-52.

4. Zenner HP, Stegmaier A, Lehner R, Baumann I, Zimmermann R. Open Tubingen titanium prostheses for ossiculoplasty: a prospective clinical trial. Otol Neurotol. 2001 Sep;22(5):582- 9.

5. Robinson M. Stapes prosthesis: stainless steel vs. teflon. Laryngoscope. 1974 Nov;84(11):1982-95.

6. BruijnAJ de, Tange RA, Dreschler WA. Comparison ofstapes prostheses: a retrospective analysis of individual audiometric results obtained after stapedotomy by implantation of a gold and a teflon piston.Am J Otol. 1999 Sep;20(5):573-80.

7. Raske M, Welling JD, Gillum T, Welling DB. Long-terco stapedectomy results with the McGee stapes prosthesis. Laryngoscope. 2001 Nov;111(11 Pt 1):2060-3.

8. Aarnisalo AA, Vasama JP, Hopsu E, Ramsay H. Long-term hearing results after stapes surgery: a 20-year follow-up. Otol Neurotol. 2003 Jul;24(4):567-71.

9. Sedwick JD, Louden CL, Shelton C. Stapedectomy vs stapedotomy. Do you really need a laser? Arch Otolaryngol Head Neck Surg. 1997 Feb;123(2):177-80.

10. Agrawal S, Parnes L. Small fenestra stapedotomy for otosclerosis in a Canadian teaching centre. J Otolaryngol. 2002 Apr;31(2):112-7.

11. Grolman W, Tange RA. First experience with a new stapes clip piston in stapedotomy. Otol Neurotol. 2005 Ju1;26(4):595-8.

12. Monsell EM, Balkany TJ, Gates GA, et al. Committee on Hearing and Equilibrium guidelines for the evaluationof results of treament of conductive hearing loss. Otolaryngol Head Neck Surg 1995;113:186-7.

13. Mangham CA Jr. Platinum ribbon-Teflon piston reduces device failure alter stapes surgery. Otolaryngol Head Neck Surg. 2000 Jul;123(1 Pt 1):108-13

14. Kos MI, Montandon PB, Guyot JP. Short- and long-terco results of stapedotomy and stapedectomy with a teflonwire piston prosthesis. Ann Otol Rhinol Laryngol. 2001 Oct;110(10):907-11.

15. Elonka DR, Derlacki EL, Harrison WH. Stapes prosthesis comparison. Otolaryngol Head Neck Surg. 1982 Mar- Apr;90(2):263-5

16. Cottle RD, Tonndorf J. Mechanical aspects of stapedial substitution. An experimental study. Arch Otolaryngol. 1966 Jun;83(6):547-53

17. Dass R, Grewal BS, Thapar SP. Human stapes and its variations. I. General features. J Laryngol Otol. 1966 Jan;80(1):11-25

18. Kwok P, Fisch U, Strutz J, May J. Stapes surgery: how precisely do different prostheses attach to the long process of the incus with different instruments and different surgeons? Otol Neurotol. 2002 May;23(3):289-95.

19. McGee TM. The loose wire syndrome. Laryngoscope. 1981 Sep;91(9 Pt 1):1478-83.

20. Schwager K. Titanium as an ossicular replacement material: results after 336 days of implantation in the rabbit. Am J Otol. 1998 Sep;19(5):569-73.

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