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Updated: Aug 12, 2025
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The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
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Audiological outcome after stapes surgery in relation to prosthesis type.
Vanessa Handke1, Parwis Agha-Mir-Salim2, Paul James3
1Department of Otorhinolaryngology, Head, Neck, Plastic and Cosmetic Surgery, Friedrichshain Clinic, Vivantes Hearing Center (HZB), Landsberger Allee 49, 10249, Berlin, Germany. vanessa.handke@vivantes.de.
Summary
The crimp prosthesis, which mimics the natural ear joint, offers better hearing outcomes after stapes surgery compared to the CliP® Piston. This difference in prosthesis type impacts the air-bone gap closure, particularly at lower frequencies.
Area of Science:
- Otolaryngology
- Audiology
- Biomedical Engineering
Background:
- Stapes prostheses are crucial for restoring hearing in otosclerosis.
- Crimp and CliP® Piston prostheses differ in their connection to the incus long process (LPI).
- The crimp prosthesis imitates the physiological incudostapedial joint (ISJ), potentially influencing audiological results.
Purpose of the Study:
- To compare the audiological outcomes of crimp versus CliP® Piston stapes prostheses.
- To evaluate the effect of prosthesis type on air-bone gap (ABG) closure.
- To determine if prosthesis design influences hearing results after stapes surgery.
Main Methods:
- Retrospective single-center study of 190 patients undergoing stapes surgery.
- Comparison of pre- and postoperative bone-conduction (BC) and air-conduction (AC) thresholds.
- Analysis of air-bone gap (ABG) at various frequencies (0.5-4 kHz) and surgery time.
Main Results:
- Postoperative BC thresholds were significantly lower between 0.5-3 kHz for both prostheses.
- Mean ABG was <10 dB in most cases, irrespective of prosthesis type.
- Crimp prosthesis demonstrated significantly better ABG closure at 0.5 kHz.
Conclusions:
- Audiological outcomes in stapes surgery are influenced by the type of prosthesis used.
- The crimp prosthesis may offer superior ABG closure due to its imitation of the ISJ.
- Crimp prostheses might be preferable when hearing aid use is anticipated post-surgery.
