Gold and titanium in the oval window: A comparison of two metal stapes prostheses

Objective: The objective of this study was to evaluate the hearing results of stapes surgery with 2 different full metal stapes prostheses. Study Design: Retrospective analyses were carried out on the pre- and postoperative hearing results obtained after primary stapedotomy with 2 different prostheses. Patients: We studied 106 patients with otosclerosis treated by stapes surgery. Intervention: Fifty-three patients had a stapedotomy with a gold piston and 53 patients received a titanium piston after stapedotomy. Main Outcome Measures: The results were compared according to mean audiometric parameters. Furthermore, the individual audiologic results were demonstrated with the Amsterdam Hearing Evaluations Plot (AREP). This method is a visual presentation of the hearing result for each operated ear. Results: These AHEPs showed that the heavier gold piston (shaft circle divide 0.4 mm and weight 10192.0 mug) gives more overclosure gain (28.3%) than the lightweight (shaft circle divide 0.4 min and weight 2541.0 mug) titanium piston (9.4% cases of overclosure). Conclusions: Because of the different properties of the 2 pistons (gold very malleable, titanium rather stiff), a choice can be made for different anatomic or pathologic situations in the operated middle ear. The "overclosure effect" of the gold piston is higher compared with the titanium piston