title: Short-term hearing results after primary stapedotomy with nitinol and teflon-platinum prostheses for otosclerosis.
abstract: The aim of this study is to determine differences in postoperative air-bone gap (ABG) after placement of teflon-platinum or nitinol middle ear prostheses in primary stapedotomy patients with otosclerosis. Thirty otosclerosis patients (24 female, 6 male; age 10-61 years) with primary stapedotomy were studied prospectively. Before and after surgery, the mean and standard deviations of the ABG were measured at eight frequencies (0.25-4 kHz). Patients were randomized into one of two groups receiving either teflon-platinum or nitinol prostheses. Hearing results were assessed 1 year after surgery. To assess the joint influence of treatment and frequency on ABG reduction, a linear mixed model was used (significance level was p = 5%). The Tukey-Kramer method was used to adjust for multiple comparisons. Significant differences were found between treatment groups (p < 0.0001) and between frequencies within the same treatment group (p < 0.0001) but no interaction (p = 0.7963), i.e. the reduction of the conductive components over frequencies was nearly parallel in both groups. Overall, patients in the Teflon group had a larger reduction of conductive components, on average 8.0 dB more reduction, than patients in the nitinol group. However, after adjusting for multiple comparisons, we could not identify a single frequency with a significant difference in reduction of conductive components. Use of the teflon-platinum prosthesis results in statistically non-significant better ABG closure at 0.25-4 kHz 1 year postoperatively than the use of the nitinol prosthesis.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Mainz Medical School, Langenbeckstr. 1, 55101 Mainz, Germany. hagouve@yahoo.de
authors.forename: Haralampos
authors.initials: H
authors.lastname: Gouveris
authors.forename: Miklós
authors.initials: M
authors.lastname: Tóth
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Koutsimpelas
authors.forename: Irene
authors.initials: I
authors.lastname: Schmidtmann
authors.forename: Wolf J
authors.initials: WJ
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D000497:Alloys; D002648:Child; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000601:surgery*; D010984:Platinum; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D013201:Stapes Surgery / Q000295:instrumentation*
chemical_list: D000497:Alloys; C013616:nitinol; D010984:Platinum; D011138:Polytetrafluoroethylene