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.