UZH-Logo

Maintenance Infos

Tight stapes prosthesis fixation leads to better functional results in otosclerosis surgery


Huber, A M; Veraguth, D; Schmid, S; Roth, T; Eiber, A (2008). Tight stapes prosthesis fixation leads to better functional results in otosclerosis surgery. Otology and Neurotology, 29(7):893-9.

Abstract

HYPOTHESIS: Tight fixation of stapes prostheses yields better functional results because sound transmission from the incus to the prosthesis is improved. BACKGROUND: The optimal prosthesis to use for otosclerosis surgery is still a matter of debate. It has been proposed that using prostheses made of Nitinol, a shape-memory metal, produces better functional results with less variability and reduced risk for middle and inner ear damage. This is thought to be because heat activation rather than manual crimping of the prosthesis loop forms a tighter fixation. METHODS: Functional results of two groups were compared 1 year after surgery. In one group were 75 cases of stapedotomy performed using Nitinol prostheses. Results were analyzed prospectively and compared with 75 retrospectively analyzed matched controls with conventional stapes prostheses. Crimping quality was measured in 23 patients by intraoperative laser Doppler interferometry (LDI). Causality was assessed by correlating results of intraoperative LDI and postoperative pure-tone thresholds. RESULTS: Nitinol and conventional prostheses yielded postoperative air-bone gaps (ABGs) of 8.0 and 11.6 dB with 71 and 43% ABG closure within 10 dB, respectively. Intraoperatively, sound transmission was improved by 2.5 dB with the Nitinol prostheses as compared with conventional prostheses. These differences were statistically significant. Intraoperative fixation quality was positively correlated to functional outcome, but results were not statistically significant. CONCLUSION: Tight fixation, as provided by Nitinol prostheses leads to improved functional results because of better sound transmission properties at the incus-prosthesis interface. The improvement in ABG closure is in the range of 3 dB pure-tone average and more pronounced at higher frequencies. Nitinol prostheses provide an effective treatment option in otosclerosis surgery.

HYPOTHESIS: Tight fixation of stapes prostheses yields better functional results because sound transmission from the incus to the prosthesis is improved. BACKGROUND: The optimal prosthesis to use for otosclerosis surgery is still a matter of debate. It has been proposed that using prostheses made of Nitinol, a shape-memory metal, produces better functional results with less variability and reduced risk for middle and inner ear damage. This is thought to be because heat activation rather than manual crimping of the prosthesis loop forms a tighter fixation. METHODS: Functional results of two groups were compared 1 year after surgery. In one group were 75 cases of stapedotomy performed using Nitinol prostheses. Results were analyzed prospectively and compared with 75 retrospectively analyzed matched controls with conventional stapes prostheses. Crimping quality was measured in 23 patients by intraoperative laser Doppler interferometry (LDI). Causality was assessed by correlating results of intraoperative LDI and postoperative pure-tone thresholds. RESULTS: Nitinol and conventional prostheses yielded postoperative air-bone gaps (ABGs) of 8.0 and 11.6 dB with 71 and 43% ABG closure within 10 dB, respectively. Intraoperatively, sound transmission was improved by 2.5 dB with the Nitinol prostheses as compared with conventional prostheses. These differences were statistically significant. Intraoperative fixation quality was positively correlated to functional outcome, but results were not statistically significant. CONCLUSION: Tight fixation, as provided by Nitinol prostheses leads to improved functional results because of better sound transmission properties at the incus-prosthesis interface. The improvement in ABG closure is in the range of 3 dB pure-tone average and more pronounced at higher frequencies. Nitinol prostheses provide an effective treatment option in otosclerosis surgery.

Citations

30 citations in Web of Science®
28 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:10 Nov 2008 15:08
Last Modified:05 Apr 2016 12:32
Publisher:Lippincott Williams & Wilkins
ISSN:1531-7129
Publisher DOI:10.1097/MAO.0b013e318184f4f0
Official URL:http://ovidsp.tx.ovid.com/spa/ovidweb.cgi?&S=IPOHFPCLBPDDHOMDMCGLFENKHPMGAA00&Abstract=S.sh.15.16.18|4|1
PubMed ID:18667934

Download

Full text not available from this repository.View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations