Autogenic and xenogenic materials in stapes surgery: retrospective analysis of 350 cases

Retrospective analysis of the postoperative hearing results in stapes surgery using autogenic materials versus xenogenic materials at the 12-month follow-up.

A total number of 350 otosclerosis patients who had undergone surgical treatment at the Otosurgery Department, Medical University of Lodz, Poland, from 1980 to 2002were included in the study. All patients were divided into four groups: group 1 (n = 54): interposition using Portmann's method; group 2 (n = 160): stapes replaced with the Shea-type prosthesis; group 3 (n = 60): platinum wire prosthesis (Zini-type), and group 4 (n = 76): Teflon piston operation (Fisch-type). The mean air-bone gap was analyzed using pure-tone audiometry (for 3 frequencies: 500, 1,000, and 2,000 Hz) before and 12 months after surgery.

The preoperative mean air-bone gaps (500, 1,000, and 2,000 Hz) were 35.6 dB for group 1, 33.2 dB for group 2, 34.7 dB for group 3, and 33.6 dB for group 4. The 12- month postoperative mean air-bone gaps (500, 1,000, and 2,000 Hz) were 19 dB for group 1, 15.9 dB for group 2, 18.4 dB for group 3, and 13.5 dB for group 4. The percentages of patients with a mean air-bone gap of 15 dB or less (500, 1,000, and 2,000 Hz) were 75% for group 1, 81.3% for group 2, 83% for group 3, and 85% for group 4.

12-month postoperative hearing results (mean air-bone gap for 3 frequencies) -- compared between the four studied groups -- showed statistically nonsignificant differences. According to our experience, Teflon piston prosthesis shows the lowest postoperative mean air-bone gap.