Pittsburgh Ear Associates, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Otol Neurotol. 2011 Jan;32(1):21-8. doi: 10.1097/MAO.0b013e3182009d10.
To understand potential causes of failure in heat-activated crimping prosthesis in stapedotomy.
Retrospective chart review of all primary and subsequent revision stapedotomy operations performed by the senior authors with heat-activated-crimping prosthesis between June 2003 and September 2009. Patients who had history of previous stapedotomy performed elsewhere were excluded.
Private neurotologic tertiary referral center.
The 335 primary stapedotomies reviewed included 190 with a SMart prosthesis and 145 with a manual-crimp De La Cruz prothesis. Twenty-one patients in the SMart prosthesis group underwent revision stapedotomy. Six patients in the De La Cruz prosthesis group underwent revision stapedotomy. Average length of time between initial and revision surgery for each prosthetic group was 16.5 months and 11 months, respectively.
Primary and revision stapedotomy using heat-activated nitinol (SMart) or manual crimp-on platinum (De La Cruz) prosthesis.
A total of 190 primary stapedotomies using heat-activated crimping prosthesis were performed between this period. There were 21 patients who had initial good hearing results that required revision or replacement with a different type of prosthesis. A common finding was lateral displacement of the prosthesis from the stapedotomy with detachment of the nitinol hook from the incus. This group of patients was compared with a control group that used manual-crimp prosthesis.
Heat-activated crimping prosthesis has been reported to enhance stapedotomy hearing outcomes on short- and long-term follow-up studies. Longitudinal analysis on its complications has not been reported. This case series demonstrated 11% rate of possible lateral displacement of the prosthesis out of the vestibule and/or incus. Reopening of the nitinol hook off the incus also was a common associated finding. Failure rates are classified. The advantages and disadvantages of this popular prosthesis are reviewed.
了解镫骨成形术热激活卷曲假体失败的潜在原因。
对所有由资深作者使用热激活卷曲假体进行的原发性和后续翻修镫骨成形术的患者进行回顾性图表分析，研究时间为 2003 年 6 月至 2009 年 9 月。排除了既往在其他地方行镫骨成形术的患者。
私人神经耳科三级转诊中心。
回顾的 335 例原发性镫骨成形术包括 190 例使用 SMart 假体和 145 例使用手动卷曲 De La Cruz 假体。SMart 假体组中有 21 例患者行翻修镫骨成形术，De La Cruz 假体组中有 6 例患者行翻修镫骨成形术。每个假体组的初次手术与翻修手术之间的平均时间分别为 16.5 个月和 11 个月。
使用热激活镍钛诺（SMart）或手动卷曲铂（De La Cruz）假体进行原发性和翻修性镫骨成形术。
在此期间共进行了 190 例原发性热激活卷曲假体镫骨成形术。有 21 例患者最初听力良好，但需要更换不同类型的假体。一个常见的发现是假体从镫骨切开处侧向移位，镍钛诺钩从砧骨上分离。将这组患者与使用手动卷曲假体的对照组进行比较。
热激活卷曲假体在短期和长期随访研究中已被报道可增强镫骨成形术的听力结果。尚未报道其并发症的纵向分析。本病例系列研究显示，有 11%的假体可能从前庭或砧骨外侧移位。镍钛诺钩从砧骨上脱落也是常见的相关发现。对失败率进行了分类。对这种流行假体的优缺点进行了综述。
