Gold and titanium in the oval window: a comparison of two metal stapes prostheses.

OBJECTIVE

The objective of this study was to evaluate the hearing results of stapes surgery with 2 different full metal stapes prostheses.

STUDY

DESIGN

Retrospective analyses were carried out on the pre- and postoperative hearing results obtained after primary stapedotomy with 2 different prostheses.

PATIENTS: We studied 106 patients with otosclerosis treated by stapes surgery.

INTERVENTION: Fifty-three patients had a stapedotomy with a gold piston and 53 patients received a titanium piston after stapedotomy.

MAIN OUTCOME MEASURES: The results were compared according to mean audiometric parameters. Furthermore, the individual audiologic results were demonstrated with the Amsterdam Hearing Evaluations Plot (AHEP). This method is a visual presentation of the hearing result for each operated ear.

RESULTS

These AHEPs showed that the heavier gold piston (shaft Ø 0.4 mm and weight 10192.0 microg) gives more overclosure gain (28.3%) than the lightweight (shaft Ø 0.4 mm and weight 2541.0 microg) titanium piston (9.4% cases of overclosure).

CONCLUSIONS

Because of the different properties of the 2 pistons (gold very malleable, titanium rather stiff), a choice can be made for different anatomic or pathologic situations in the operated middle ear. The "overclosure effect" of the gold piston is higher compared with the titanium piston.