A new self-fixing and articulated malleus grip stapedectomy prosthesis.

A new prosthesis for malleus-grip stapedectomy is presented: the Clip(R) Piston MVP according to Häusler. The titanium piston is equipped with a self-fixing clip mechanism for automatic fixation of the prosthesis on the proximal malleus handle as well as a ball and socket articulation allowing easy introduction of the piston at an optimal angle into the oval window as well as adjustment of the insertion depth. A first series of malleus-grip stapedectomies performed with the Clip Piston MVP shows a hearing gain of 20 to 50 dB and a residual air-bone gap of < or =20 dB in all cases. In one patient, revision surgery was necessary because of piston ejection from the oval window. It appears that with the new Clip Piston MVP the previously difficult surgery of malleus-grip stapedectomy has become straight forward and technically simpler.