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.