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Long-term stapedectomy results with the McGee stapes prosthesis
M Raske1, J D Welling, T Gillum
1Department of Otolaryngology, The Ohio State University, Columbus, Ohio, USA.
The Laryngoscope
|January 22, 2002
Summary
The McGee stapes prosthesis showed a unique dislocation pattern in stapedectomy patients, with early failures due to platinum ribbon displacement. Long-term follow-up revealed an 11.2% failure rate for the McGee piston.
Area of Science:
- Otolaryngology
- Neurosurgery
- Biomedical Engineering
Background:
- Stapedectomy is a surgical procedure to restore hearing in patients with otosclerosis.
- The McGee stapes prosthesis is a type of piston prosthesis used in stapedectomy.
- Long-term outcomes of stapes prostheses are crucial for patient management.
Purpose of the Study:
- To evaluate the long-term efficacy and failure patterns of the McGee stapes prosthesis.
- To compare the failure modes of the McGee piston with the Robinson cup prosthesis.
Main Methods:
- Retrospective analysis of 170 stapedectomies (120 primary, 50 revision) performed between 1989 and 1999.
- Audiometric data and findings from repeat explorations were reviewed.
- Failure rates and patterns were compared between the McGee piston and Robinson cup prostheses.
Main Results:
- The McGee piston had an 11.2% failure rate for air-bone gap closure over 10 years.
- A unique failure pattern was observed: lateral displacement of the platinum ribbon from the incus, leading to piston extrusion.
- Failures with the McGee piston occurred significantly earlier (2.5 years) compared to the Robinson cup (8.6 years).
Conclusions:
- The McGee piston exhibits a distinct dislocation pattern attributed to its malleable platinum ribbon and loosening of the crimped "shepherd's crook" over time.
- The failure mechanism of the McGee piston differs from other prostheses, necessitating careful consideration in stapedectomy procedures.