Grolman W, Tange R A
Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Otol Neurotol. 2005 Jul;26(4):595-8. doi: 10.1097/01.mao.0000178132.89353.54.
Hearing results after 23 implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated. This new type of stapes piston was designed to avoid the crimping onto the incus in stapedotomy. This one clip fits all designs and enables solid fixation by clicking the prosthesis onto the long process of the incus without crimping.
A retrospective pilot study was carried out by microcomputer of the preoperative and postoperative audiological results of patients in whom the titanium-clip stapes piston prosthesis was implanted.
Ear, nose and throat department of Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
23 Patients underwent a stapedotomy for hearing improvement suffering from otosclerosis. implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated.
INTERVENTION(S): The stapedotomy was performed with the àWengen Clip Piston prosthesis.
MAIN OUTCOME MEASURE(S): Pre and postoperative audiograms were used to evaluate the hearing gain improvement with the new stapes piston. Especially we looked at the airbone gap closure and the sensorineural hearing after the surgical procedure and compared these with the ones before surgery.
The hearing results showed a closure of the pure-tone average air-bone gap to within 10 dB in 56.6% of cases (10 of 23 implantations) and to within 20 dB in 100% (23 of 23 implantations). A residual air-bone gap of greater than 20 dB was seen in the present pilot study. Postoperative overclosure of bone-conduction thresholds was discovered only for the frequency of 2 kHz. Sensorineural hearing loss greater than 10% did not occur, and there was no decline in the speech discrimination.
The use of a newly designed titanium-clip stapes piston prosthesis with a diameter of 0.4 mm gives good results in cases of stapedotomy for otosclerosis. The titanium-clip design is a new development in the evolution of stapes piston prostheses. Surgical introduction, placement, and fixation are not always easy, depending on the anatomy of the middle ear and the thickness of the fixation area on the long process of the incus.
评估23例耳硬化症患者植入新设计的钛夹镫骨活塞假体（àWengen Clip Piston假体）后的听力结果。这种新型镫骨活塞旨在避免在镫骨手术中压接在砧骨上。这种单夹式设计适用于所有情况，通过将假体扣在砧骨长突上实现牢固固定，无需压接。
通过微机对植入钛夹镫骨活塞假体患者的术前和术后听力学结果进行回顾性初步研究。
荷兰阿姆斯特丹大学学术医疗中心耳鼻喉科。
23例因耳硬化症接受镫骨手术以改善听力的患者。评估了耳硬化症患者植入新设计的钛夹镫骨活塞假体（àWengen Clip Piston假体）的情况。
使用àWengen Clip Piston假体进行镫骨手术。
术前和术后听力图用于评估新型镫骨活塞的听力改善情况。特别是观察了手术后气骨导间距的闭合情况以及感音神经性听力，并与手术前进行比较。
听力结果显示，56.6%的病例（23例植入中的10例）纯音平均气骨导间距闭合至10 dB以内，100%（23例植入中的23例）闭合至20 dB以内。在本初步研究中发现有大于20 dB的残余气骨导间距。仅在2 kHz频率发现术后骨导阈值过度闭合。感音神经性听力损失大于10%未发生，言语辨别能力也未下降。
使用新设计的直径为0.4 mm的钛夹镫骨活塞假体在耳硬化症镫骨手术中取得了良好效果。钛夹设计是镫骨活塞假体发展中的一项新进展。手术引入、放置和固定并不总是容易的，这取决于中耳的解剖结构以及砧骨长突固定区域的厚度。
