[Long-term results of stapes surgery with the Schuknecht wire-teflon prosthesis]

Early and late postoperative findings in 78 cases of stapedial surgery with 0.6 mm Schuknecht Teflon Wire Pistons only, performed from 1983 to 1987, were analysed to evaluate the supposition of an inverse relationship of the size of the footplate fenestration and functional long-term results. In respect of the size of fenestration our surgical strategy resulted in 3 different situations: stapedotomy (26)--partial platinectomy (34)--stapedectomy (19). Mean air conduction thresholds for frequencies 0.5-4 kHz were evaluated preoperatively, one month and > 5 years postoperatively. The results were postoperatively significantly better in all 3 groups without significant intergroup differences. > 5 years postoperatively the best results were seen in the partial platinectomy group better than after stapedotomy and significantly better than in the stapedectomy group. With regard to overclosure, closure of the air bone gap and deterioration of bone conduction thresholds at 4 kHz for the same groups, no significant differences were noticed. In conclusion, the best long-term results were obtained after partial platinectomy, i.e. there was no inverse relation of the size of the footplate perforation and the best results. The perforation should be large enough to prevent tilting of the piston at the edge. Removal of larger parts should be omitted. In case of early mobilisation and stapedectomy good long-term results can still be expected.