[A new self-retaining titanium-gold stapes prosthesis]

Various aspects of stapes surgery have been improved since its introduction in 1958 by Shea. However, fixation of the prosthesis on the long process of the incus remains difficult. Furthermore, the functional result of crimping cannot be predicted. Necrosis of the lenticular process still occurs. A new stapes prosthesis has been developed with the Kurz Co. The use of titanium allowed an innovative design: titanium has a shape memory, and a clip was constructed which uses this memory for fixation on the incus. Two new instruments were also developed to facilitate application of the prosthesis: a prosthesis inserter and a prosthesis crimper. The clip does not strangulate the incus; it is attached only to the superior and inferior surface of the incus, which are the crucial locations for mechanical transmission of the piston-like movements of the ossicular chain. Avoidance of circumferential attachment should reduce the risk of incus necrosis. Once the clip is pushed onto the incus no further crimping is necessary. The piston is of pure gold, as in this company's gold piston which has been in use for many years. In future the prosthesis may be all-titanium.