First experience with a new titanium clip stapes prosthesis and a comparison with the earlier model used in stapes surgery.

Abstract

The aim of the study was to gain the first clinical experience with a new titanium clip prosthesis in stapes surgery, and to compare this model with its predecessor. We placed particular emphasis on the practicability of fixing the prosthesis to the long process of the incus and on the postoperative improvement in hearing. Retrospective chart review. The study included 23 patients who had a CliP Piston àWengen fitted and 21 patients with a Soft CliP Piston (both from Kurz Medizintechnik, Dusslingen, Germany). Air and bone conduction were tested preoperatively and 5 to 6 weeks after surgery in all patients, as well as after about 1 year in a subgroup. We found a mean air-bone gap of 8.5 +/- 5.2 dB in the frequencies 0.5, 1, 2, and 3 kHz for the patients with a CliP Piston àWengen at follow-up audiometry after an average of 31 days, and of 6.4 +/- 3.7 dB for 11 patients after 412 days. The corresponding figures for patients with Soft CliP Pistons were 8.9 +/- 4.1 dB after 44 days, and 6.3 +/- 5.6 dB for 10 patients after 419 days. There were no statistically significant differences. All the prostheses were implanted without difficulty. The two stapes prostheses studied gave good early audiometric results that showed no difference. After a short learning period, both could be pushed onto the long process of the incus with similar ease, although subjectively the new design of the Soft CliP seemed to adapt better to the different diameters of the process and took up less space in the middle ear.