title: First experience with a new stapes clip piston in stapedotomy.
abstract: OBJECTIVE
  Hearing results after 23 implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated. This new type of stapes piston was designed to avoid the crimping onto the incus in stapedotomy. This one clip fits all designs and enables solid fixation by clicking the prosthesis onto the long process of the incus without crimping.
  
  
  METHODS
  A retrospective pilot study was carried out by microcomputer of the preoperative and postoperative audiological results of patients in whom the titanium-clip stapes piston prosthesis was implanted.
  
  
  METHODS
  Ear, nose and throat department of Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  
  
  METHODS
  23 Patients underwent a stapedotomy for hearing improvement suffering from otosclerosis. implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated.
  
  
  METHODS
  The stapedotomy was performed with the àWengen Clip Piston prosthesis.
  
  
  METHODS
  Pre and postoperative audiograms were used to evaluate the hearing gain improvement with the new stapes piston. Especially we looked at the airbone gap closure and the sensorineural hearing after the surgical procedure and compared these with the ones before surgery.
  
  
  RESULTS
  The hearing results showed a closure of the pure-tone average air-bone gap to within 10 dB in 56.6% of cases (10 of 23 implantations) and to within 20 dB in 100% (23 of 23 implantations). A residual air-bone gap of greater than 20 dB was seen in the present pilot study. Postoperative overclosure of bone-conduction thresholds was discovered only for the frequency of 2 kHz. Sensorineural hearing loss greater than 10% did not occur, and there was no decline in the speech discrimination.
  
  
  CONCLUSIONS
  The use of a newly designed titanium-clip stapes piston prosthesis with a diameter of 0.4 mm gives good results in cases of stapedotomy for otosclerosis. The titanium-clip design is a new development in the evolution of stapes piston prostheses. Surgical introduction, placement, and fixation are not always easy, depending on the anatomy of the middle ear and the thickness of the fixation area on the long process of the incus.
authors: Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. W.Grolman@AMC.UVA.nl
authors: W
authors: W
authors: Grolman
authors: R A
authors: RA
authors: Tange
mesh_terms: D001299:Audiometry; D001309:Auditory Threshold; D001844:Bone Conduction; D003936:Diagnosis, Computer-Assisted; D004867:Equipment Design; D005260:Female; D006309:Hearing; D034381:Hearing Loss / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000150:complications* / Q000601:surgery*; D010865:Pilot Projects; D011184:Postoperative Period; D012189:Retrospective Studies; D013201:Stapes Surgery; D014025:Titanium
chemical_list: D014025:Titanium