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Updated: Jun 17, 2025
Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach
Published on: March 5, 2022
Comparison of Outcomes with the Use of Different Heat-Activated Crimping Prostheses in Stapedotomy
Garrett Ni1, Stylianos Monos2, Sarah Kortebein3
1Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
Objective:
To determine differences in failure rate and hearing outcomes of a completely encircling heat-activated crimping prosthesis (SMart 360°) compared to partially encircling prosthesis (SMart).
Study Design:
Retrospective chart review.
Setting:
Private neurotology tertiary referral center.
Patients:
Patients who underwent stapedotomies performed by the senior authors from 2008 to 2019 using the SMart prosthesis and SMart 360° prothesis.
Interventions:
Stapedotomy operations with placement of a SMart or SMart 360° prosthesis.
Main Outcome Measures:
Incidence of early failure requiring revision surgery. Differences in preoperative air-bone gap (ABG) compared to postoperative ABG at 3 months, 1 year, and 2 years after surgery.
Results:
A total of 228 stapedotomies were performed (SMart n = 48 and SMart 360° n = 180). Mean preoperative ABG for SMart and SMart 360° were 26.15 and 29 dB, respectively. The mean difference in ABG for the SMart at 3 months, 1 year, and 2 years were 17, 18, and 11 dB, respectively. The mean difference in ABG for the SMart 360° at 3 months, 1 year, and 2 years were 20, 20, and 19 dB. ABG differences at 3 months (p = 0.10) and 1 year (p = 0.36) were not statistically different. The failure rate for the SMart prosthesis was 12.5% and for the SMart 360° 2.2% (p = 0.002).
Conclusions:
There were no statistically significant differences in ABG changes for SMart compared to SMart 360°. The Smart 360 corrects the problem with early failure seen with the Smart prosthesis.
Professional Practice Gap And Educational Need:
Determination of most efficacious stapes prosthesis.
Learning Objective:
Which stapes prosthesis produces better hearing results with fewer failures.
Desired Result:
To disseminate information necessary to choose the best stapes prosthesis for patients.
Level Of Evidence:
Level III.
Indicate Irb Or Iacuc:
2022-029-agh.
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