Titanium and Platinum-Fluoroplastic Stapes Prostheses Visualization on Cone Beam Computed Tomography and...

Area of Science:

• Otolaryngology
• Medical Imaging
• Biomaterials

Background:

• Stapes prostheses are crucial for hearing restoration after stapedotomy.
• Imaging challenges arise due to metal artifacts from prostheses, impacting diagnosis for hearing loss or vertigo.
• Cone beam computed tomography (CBCT) is increasingly recognized for its potential in reducing metal artifacts.

Purpose of the Study:

• To compare the visualization accuracy of stapes prostheses using CBCT versus traditional CT.
• To evaluate the impact of prosthesis material (platinum-fluoroplastic vs. titanium) on imaging quality.
• To assess the utility of CBCT in identifying prosthesis position and potential complications like vestibular intrusion.

Main Methods:

• Retrospective analysis of 41 patients (45 implanted ears) with platinum-fluoroplastic or titanium stapes prostheses.
• Comparison of imaging data from CT and CBCT, focusing on prosthesis visualization, length, and position.
• Correlation of imaging findings with intraoperative data and audiologic results.

Main Results:

• Functional length measurements showed a mean error of -0.17 mm (±0.20).
• Platinum-fluoroplastic prostheses were significantly underestimated in length compared to titanium.
• A blinded neuroradiologist misidentified the position of two platinum-fluoroplastic prostheses due to underestimation of length and poor radiodensity.

Conclusions:

• Surgeons and radiologists must recognize the varying radiologic characteristics of different stapes prosthesis materials.
• CBCT presents a viable imaging alternative for post-stapes surgery evaluation, potentially offering reduced radiation exposure.
• CBCT may improve the assessment of prosthesis position in patients experiencing vertigo or hearing loss after stapedotomy.