Department of Otorhinolaryngology, Head, Neck, Plastic and Cosmetic Surgery, Friedrichshain Clinic, Vivantes Hearing Center (HZB), Landsberger Allee 49, 10249, Berlin, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery and Communication Disorders, HELIOS-Clinic Berlin-Buch, Berlin, Germany.
Eur Arch Otorhinolaryngol. 2023 Jul;280(7):3171-3176. doi: 10.1007/s00405-023-07822-3. Epub 2023 Jan 28.
Different techniques are used to fix crimp and CliP® Piston stapes prostheses to the long process of the incus (LPI). The CliP® Piston provides a stiff connection in contrast to the static bended loop of the crimp prosthesis, which imitates the physiological incudostapedial joint (ISJ) and thereby potentially leads to different hearing outcome.
In a retrospective single-center study of German-speaking one hundred and ninety patients who underwent stapes surgery CliP® Piston or crimp prostheses between the years of 2016 and 2019 by the same surgeon and in the same setting. Pre- and postoperative bone- (BC) and air-conduction (AC) pure-tone thresholds, pre- and postoperative air-bone gap (ABG) for 0.5, 1, 1.5, 2, 3, 4 kHz and the surgery time were examined.
The postoperative bone conduction thresholds were significantly lower in the frequencies between 0.5 and 3 kHz and the mean ABG was < 10 dB in most cases independent of the prosthesis used. Crimp prosthesis showed a significantly better closure of the ABG at 0.5 kHz.
The audiological outcome after stapes surgery is dependent on the type of prosthesis used, as reflected by the frequency-specific air-bone gap. The better ABG closure with the crimp prosthesis might be the result of the connection to the LPI imitating the physiological ISJ. The crimp prosthesis may be the better choice if use of hearing aids is expected postoperatively.
为了将 CliP® 活塞式镫骨假体和卷曲式镫骨假体固定在砧骨长突（LPI）上，采用了不同的技术。与卷曲式假体的静态弯曲环不同，CliP® 活塞提供了刚性连接，模仿了生理砧镫关节（ISJ），从而可能导致不同的听力结果。
在一项回顾性的单中心研究中，对 190 名德国患者进行了研究，这些患者在 2016 年至 2019 年间由同一位外科医生在相同的环境下接受了 CliP® 活塞或卷曲式假体的镫骨手术。检查了术前和术后的骨（BC）和空气传导（AC）纯音阈值、术前和术后 0.5、1、1.5、2、3、4 kHz 的气骨间隙（ABG）以及手术时间。
术后骨导阈值在 0.5 至 3 kHz 之间显著降低，大多数情况下使用两种假体的平均 ABG 均<10 dB。卷曲式假体在 0.5 kHz 时能更好地闭合 ABG。
镫骨手术后的听力结果取决于所使用的假体类型，这反映在特定频率的气骨间隙上。卷曲式假体更好地闭合 ABG 可能是由于与 LPI 的连接模仿了生理 ISJ。如果预计术后需要使用助听器，卷曲式假体可能是更好的选择。
