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Einsatz eines Nickel-Titan-Piston mit Memory-Eigenschaften

Erster Erfahrungsbericht

First experiences with a new nickel-titanium piston with a shape memory feature

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Zusammenfassung

Hintergrund

Auswertung der Untersuchung einer neuen Steigbügelprothese mit „Memory-Eigenschaften“ der Drahtschlinge (sog. SMart(tm)-Piston).

Patienten und Methode

Bei 15 Patienten im Durchschnittsalter von 43,4 (28–71) Jahren wurde bei einer routinemäßig geplanten Steigbügeloperation als Prothese ein SMart(tm)-Piston mit einem Schaftdurchmesser von 0,5 mm und einer Länge zwischen 4,25 und 4,5 mm eingesetzt. Bei 5 Patienten wurde zur Erwärmung und Fixierung der Prothese der CO2-Laser und 10-mal die bipolare Pinzette benutzt. Nach durchschnittlich 21,9 bzw. 435 Tagen erfolgte eine erste bzw. bei 10 Patienten eine weitere postoperative tonaudiometrische Testung.

Ergebnisse

Die mittlere postoperative verbliebene Schallleitungskomponente („air-bone gap“, ABG) betrug 8,7 dB ±7,7 dB. Hierbei hatten 73% eine ABG von 10 dB oder weniger und bei 100% war die ABG <20 dB. Nach 435 Tagen lag die ABG bei 4,4 dB ±2,4 dB, und bei all diesen Patienten war die ABG kleiner als 10 dB.

Schlussfolgerung

Ein kritischer und schwieriger Arbeitsschritt der Steigbügeloperation, die Fixierung der Prothese am langen Ambossschenkel, wird mit diesem Piston deutlich einfacher. Abzuwarten sind die Langzeitergebnisse an größeren Patientenkollektiven.

Abstract

Background

The aim of this study was to describe a new stapes prosthesis with memory characteristics for wire crimping (SMar-Piston).

Patients and methods

This technique was used in 15 patients (mean age 43.4 years; range 28–71) undergoing routine stapes surgery. SMart-Piston prostheses with a shaft diameter of 0.5 mm and length ranging from 4.25–4.5 mm were used. Heat induced wire crimping was performed by CO2 laser in five patients, and by bipolar diathermy forceps in ten patients. In 15 patients, postoperative audiological testing was performed at an average 21.9 days and in another 10 again after 435 days following surgery.

Results

The median observed air-bone-gap (ABG) postoperatively was 8.7 dB±7.7 dB. A total of 73% of all patients had an ABG of 10 dB or less, and all patients had less than 20 dB. In the ten patients controlled after 435 days, the ABG was 4.4 dB±2.4 dB. It was lower than 10 dB in all individuals.

Discussion

A critical point in every stapes surgery, the prosthesis fixation to the incus, is greatly facilitated by this novel technique. Long-term results in a larger group of patients are pending.

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Authors and Affiliations

  1. Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum, Waldstraße 1, 91054, Erlangen

    J. Hornung, J. Zenk, B. Schick, J. Wurm & H. Iro

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  1. J. Hornung
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  2. J. Zenk
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  3. B. Schick
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  4. J. Wurm
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  5. H. Iro
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Correspondence to J. Hornung.

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Hornung, J., Zenk, J., Schick, B. et al. Einsatz eines Nickel-Titan-Piston mit Memory-Eigenschaften. HNO 55, 104–108 (2007). https://doi.org/10.1007/s00106-006-1432-5

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  • DOI: https://doi.org/10.1007/s00106-006-1432-5

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