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Gold and titanium in the oval window: a comparison of two metal stapes prostheses
Rinze A Tange1, Wilko Grolman, Wouter A Dreschler
1Department of Otolaryngology-Head and Neck Surgery, Division of Otology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. R.A.Tange@amc.uva.nl
Objective:
The objective of this study was to evaluate the hearing results of stapes surgery with 2 different full metal stapes prostheses.
Study Design:
Retrospective analyses were carried out on the pre- and postoperative hearing results obtained after primary stapedotomy with 2 different prostheses.
Patients:
We studied 106 patients with otosclerosis treated by stapes surgery.
Intervention:
Fifty-three patients had a stapedotomy with a gold piston and 53 patients received a titanium piston after stapedotomy.
Main Outcome Measures:
The results were compared according to mean audiometric parameters. Furthermore, the individual audiologic results were demonstrated with the Amsterdam Hearing Evaluations Plot (AHEP). This method is a visual presentation of the hearing result for each operated ear.
Results:
These AHEPs showed that the heavier gold piston (shaft Ø 0.4 mm and weight 10192.0 microg) gives more overclosure gain (28.3%) than the lightweight (shaft Ø 0.4 mm and weight 2541.0 microg) titanium piston (9.4% cases of overclosure).
Conclusions:
Because of the different properties of the 2 pistons (gold very malleable, titanium rather stiff), a choice can be made for different anatomic or pathologic situations in the operated middle ear. The "overclosure effect" of the gold piston is higher compared with the titanium piston.
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