Long-term stapedectomy results with the McGee stapes prosthesis.

Abstract

To report long-term follow up on patients undergoing stapedectomy with the McGee stapes prosthesis. A retrospective case series. Charts recording 170 stapedectomies (120 primary and 50 revision stapedectomies) from 1989 to 1999 were analyzed, and audiometric data and the findings at repeat exploration reported. Over a 10-year period, 11.2% of patients had failure of their initial air-bone gap closure with the McGee piston. Seventy-seven percent (in 10 of 13 patients) of McGee pistons that failed were found to have the platinum ribbon displaced laterally from the incus and the piston pushed out of the stapedotomy. The failure rate was not significantly different (P =.72) from that in our patients who underwent placement of a Robinson cup prosthesis (9.5%), but the pattern of displacement was unique. Failures occurred earlier with the McGee piston (average time to failure of 2.5 y) than with the Robinson cup (average time to failure of 8.6 y). The McGee piston was found to have a unique pattern of dislocation that is likely related to the malleable nature of the platinum ribbon and loosening of the crimped "shepherd's crook" over time.