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Updated: Jun 19, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages

Published on: March 24, 2023

Hearing results using the SMart piston prosthesis.

Jose N Fayad¹, Maroun T Semaan, Josh C Meier

¹House Ear Institute and House Ear Clinic, Los Angeles, California 90057, USA. jfayad@hei.org

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology

|October 10, 2009

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The SMart piston prosthesis, a novel nitinol device for stapedotomy, demonstrates comparable hearing results and rare complications versus conventional prostheses. This self-crimping device offers a safe alternative for stapes surgery.

Area of Science:

Otolaryngology
Biomaterials Science
Neurosurgery

Background:

Stapedotomy is a surgical procedure to restore hearing in patients with otosclerosis.
Conventional stapes prostheses require manual crimping, a step that can influence surgical outcomes.
Nitinol-based, heat-activated, self-crimping prostheses offer a potential advancement in stapedotomy techniques.

Purpose of the Study:

To evaluate the hearing outcomes and postoperative complications associated with the SMart piston prosthesis.
To compare the performance of the SMart prosthesis with conventional stainless steel or platinum piston prostheses.
To assess the safety and reliability of this novel self-crimping stapes prosthesis.

Main Methods:

Retrospective chart review of 416 ears undergoing stapedotomy.

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Comparison of 306 ears with SMart prostheses and 110 ears with conventional prostheses.

Analysis of audiometric data (pure-tone average, air-bone gap) and complication rates.

Main Results:

Audiometric results, including mean postoperative pure-tone average and air-bone gap closure, were similar between the SMart and conventional prosthesis groups.
No significant differences were observed in complication rates (vertigo, tinnitus) between the two groups.
High-frequency bone conduction overclosure was infrequent in both groups.

Conclusions:

The nitinol-based SMart prosthesis is a safe and effective alternative to conventional stapes prostheses for stapedotomy.
The self-crimping feature of the SMart prosthesis eliminates manual crimping without compromising audiometric outcomes.
While complications are rare, further long-term follow-up is necessary to confirm the sustained stability of the SMart prosthesis.