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Comparison of Audiometric and Functional Outcomes Between the Standard and Modified 360 Nitinol Shape Memory Stapes Prostheses

Lavy, Jeremy; Huins, Charlie; Khalil, Sherif; Hall, Andrew; Hughes, Owain

doi: 10.1097/MAO.0000000000000816

Objective To compare audiometric and functional outcomes between two designs of heat-activated self-crimping stapes prostheses—a modified shape memory circumferential nitinol-Teflon piston versus its predecessor—in patients with otosclerosis.

Study Design A retrospective analysis of preoperative and postoperative hearing thresholds.

Setting Tertiary referral center and teaching hospital.

Patients One hundred sixty-three consecutive procedures of primary stapes surgery for clinically proven otosclerosis in 108 women and 55 men with an average age of 46 years.

Intervention Stapedotomy and insertion of either a standard or a circumferential stapes prosthesis.

Main Outcome Measures Four-frequency pure-tone average preoperative and postoperative air-bone thresholds were recorded. A secondary outcome measure was stability of the implant, as measured by failure rates.

Results Success of closure of the air-bone gap to within 10 dB was achieved in 97% and comparable in both groups (original prosthesis, 23.6; standard deviation, 7.3, with the average reduction seen in the circumferential prosthesis group being 22.6, standard deviation, 5.6). All the differences were not statistically significant using two-way analysis of variance. Failure rate for the original piston was 6%, with no failures seen with the circumferential piston.

Conclusion Both prostheses showed comparable postoperative hearing outcomes, with the circumferential prosthesis being found to be more stable.

ENT Department, Royal National Throat, Nose & Ear Hospital, London, United Kingdom

Address correspondence and reprint requests to Charlie Huins, F.R.C.S. (ORL-HNS), Professorial Unit, Royal National Throat, Nose & Ear Hospital, 330-332 Gray’s Inn Rd, London WC1X 8DA, United Kingdom; E-mail:

The authors disclose no conflicts of interest.

Copyright © 2015 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company