nitinol and Hearing-Loss

The limitations of manual prosthesis crimping in hearing restoration surgery for otosclerosis are thought to have a key role in the occurrence of incomplete postoperative elimination of conductive hearing loss and postoperative recurrences of conductive hearing loss. To eliminate manual crimping, the self-crimping, shape-memory alloy Nitinol stapes piston was introduced in nine otosclerosis patients. The results were compared with those in a database of surgeries performed with conventional titanium pistons. The effects of the self-crimping Nitinol prosthesis on the postoperative elimination of conductive hearing loss and its postoperative variations were investigated. The variations of postoperative residual conductive hearing loss were significantly smaller and the extent of conductive hearing-loss elimination greater in the Nitinol group. The mean postoperative residual conductive hearing loss was smaller in the Nitinol group. The postoperative stability of conductive hearing loss elimination was similar in both patient groups. Preliminary results suggest that the self-crimping shape-memory alloy Nitinol stapes piston overcomes the drawbacks of manual crimping in hearing restoration surgery for otosclerosis.

Topics: Adult; Aged; Alloys; Hearing Loss; Humans; Middle Aged; Ossicular Prosthesis; Ossicular Replacement; Osteosclerosis; Prosthesis Design; Stapes Surgery; Treatment Outcome

To analyze health-related quality of life (HRQoL) and audiological results after stapes surgery using a Nitinol Head Prosthesis (NHP).. Study-Design Prospective longitudinal study. Patients Patients undergoing stapes surgery for otosclerosis and stapes reconstruction with a NHP between January 2018 and December 2018 (n = 48). Intervention Audiological measurements preoperatively and at 6 months follow-up as well as two questionnaires assessing HRQoL, i.e., the Stapes Plasty Outcome Test 25 (SPOT-25) and the Glasgow Benefit Inventory (GBI). Main outcome measures Correlation of pure tone average (4PTA 0.5-3 kHz) with questionnaires assessing HrQOL preoperatively and at follow-up after stapes surgery.. Patients showed a significantly reduced air-bone-gap (ABG, 0.5, 1, 2, 3 kHz) at the follow up visit (median: 11.3 dB, IQR 5.0-14.4) compared to the preoperative measurements (median 27.5 dB, IQR 21.9-36.3). Disease-specific HRQoL improved significantly in all scales of the SPOT-25 apart from the subscore "tinnitus". Postoperatively, the subscore "hearing function" correlated well only with the ABG (r = 0.59, p = 0.001). The SPOT-25 and GBI total scores showed a moderate negative correlation (r = - 0.59, p = 0.008).. Stapes surgery leads to significant improvements of hearing and the HRQoL. However, correlations between HRQoL questionnaire scores and the audiometric outcomes were inconclusive, indicating that the use of HRQoL measures for the assessment of stapedotomy outcomes to complement objective outcomes should be encouraged.

Topics: Adult; Alloys; Audiometry; Biocompatible Materials; Female; Follow-Up Studies; Hearing Loss; Hearing Tests; Humans; Longitudinal Studies; Male; Middle Aged; Ossicular Prosthesis; Otosclerosis; Prospective Studies; Prosthesis Implantation; Quality of Life; Stapes Surgery

The aim of this retrospective study was to compare the 3-month postoperative hearing results following laser stapedotomy with the use of NiTiBOND versus Nitinol prostheses (31 and 39 patients, respectively). The operations were performed between September 2012 and September 2014, and between March 2006 and December 2012 regarding NiTiBOND and Nitinol, respectively. Twenty of the consecutive 31 patients were female and 11 were male for NiTiBOND, while 11 were male and 28 were female for Nitinol. The mean age was 43.8 years (range 22-61) and 46.9 years (range 28-83) for NiTiBOND and Nitinol, respectively. No significant cochlear trauma was documented postoperatively. The mean air-bone gap (ABG) for the frequencies 0.5, 1, 2 and 3 kHz at the 3-month postoperative follow-up was 7.6 dB (SD 4.7), and 9.3 dB (SD 4.1) for NiTiBOND and Nitinol, respectively. The differences between the mean pre- (p = 0.179), and postoperative (p = 0.059) ABG of the two groups were not significant. ABG closure within 10 dB was achieved in 77.4 and 59 % for NiTiBOND and Nitinol, respectively, the difference was not significant (p = 0.10). Two cases of delayed facial paralysis occurred, 1 with Nitinol and 1 with the NiTiBOND. All patients attained an ABG <20 dB following surgery. Laser stapedotomy with the application of either heat-memory piston prosthesis allowed an easy and minimally invasive approach with excellent short-term hearing results when the NiTiBOND prosthesis was applied. Laser application allowed manipulation in a bloodless environment and avoided manual crimping of the incus.

Topics: Adult; Aged; Aged, 80 and over; Alloys; Female; Hearing Loss; Humans; Male; Middle Aged; Ossicular Prosthesis; Prosthesis Design; Prosthesis Implantation; Retrospective Studies; Stapes Surgery; Treatment Outcome; Young Adult