Enhanced hearing in heat-activated-crimping prosthesis stapedectomy

Abstract

Objectives Compare short-term hearing outcomes with a heat-activated-crimping versus manual-crimping stapedectomy prosthesis. Study Design Retrospective chart review. Setting Tertiary care neurotology referral center. Patients 219 charts reviewed. Intervention Laser stapedectomy. Main Outcome Measures Audiometric. Methods Retrospective study comparing postoperative hearing in manual-crimp prostheses stapedectomies versus heat-activated-crimp prostheses stapedectomies. Results Of the 219 patients reviewed, 94 met inclusion criteria for the study, with 47 receiving manual-crimp prosthesis and 47 receiving heat-activated-crimp prosthesis. Short-term poststapedectomy air-bone gaps, long-term air-bone gaps, long-term pure-tone averages, and long-term air-bone gap closures were significantly better for heat-activated-crimp versus manual-crimp prostheses. Conclusion Heat-activated-crimping prostheses demonstrated enhanced stapedectomy hearing outcomes versus manual-crimping prostheses on short- and long-term follow-up. Three-dimensional reorientation of the heat-activated prosthesis may enhance the hearing outcome; however, theoretical nickel allergy considerations, effects of case selection, follow-up duration, possible eventual loosening of the heat-activated crimp, and long-term incus necrosis are considerations requiring continued longitudinal analysis.