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The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Hearing results in stapes surgery using two different prosthesis
M Casale1, A De Franco, F Salvinelli
1Area of Otolaryngology, Interdisciplinary Center for Biomedical Research (CIR), University Campus Bio-Medico, Rome, Italy. m.casale@unicampus.it
Aim Of The Study:
Evaluation of hearing results after implantation of a fluoroplastic-platinum piston (FP) and of a titanium piston (T) with a shaft diameter of respectively 0.6 mm and 0.4 mm, in cases of otosclerosis requiring stapedotomy.
Material And Methods:
Pre-operative and post-operative hearing results obtained after primary stapedotomy by implantation of 30 FP and 30 T performed by the same expert author (C.Z.) were reviewed. In each patient we evaluated pre- and post-operative auditory thresholds, as recommended.
Results:
All patients of both groups showed a significant air-bone gap (ABG) improvement for all frequencies after surgery ( P < 0. 001). Post-operative ABG comparison between the two groups showed a better ABG for lower frequencies in the FP group and for higher frequencies in the T group, but the difference was not significant. No post-operative complications, including sensorineural hearing loss, were found. Bone conduction improvement was better in the FP group than in the T one and this difference was statistically significant at 1000 and 2000 Hz. There was no statistically significant difference in the post-operative outcomes between the two prosthesis. Better results of FP for lower frequencies suggest that an increase in diameter of the prosthesis results in a greater improvement in the hearing threshold at low frequencies, while a decrease of diameter results in a greater improvement in the hearing threshold at high frequencies, as indicated by previous international studies.
Conclusion:
Our data shows that titanium piston is a as good as fluoroplastic piston in stapes surgery for otosclerosis.
