Comparison of Outcomes with the Use of Different Heat-Activated Crimping Prostheses in Stapedotomy.

Objective: To determine differences in failure rate and hearing outcomes of a completely encircling heat-activated crimping prosthesis (SMart 360°) compared to partially encircling prosthesis (SMart).

Study Design: Retrospective chart review.

Setting: Private neurotology tertiary referral center.

Patients: Patients who underwent stapedotomies performed by the senior authors from 2008 to 2019 using the SMart prosthesis and SMart 360° prothesis.

Interventions: Stapedotomy operations with placement of a SMart or SMart 360° prosthesis.

Main Outcome Measures: Incidence of early failure requiring revision surgery. Differences in preoperative air-bone gap (ABG) compared to postoperative ABG at 3 months, 1 year, and 2 years after surgery.

Results: A total of 228 stapedotomies were performed (SMart n = 48 and SMart 360° n = 180). Mean preoperative ABG for SMart and SMart 360° were 26.15 and 29 dB, respectively. The mean difference in ABG for the SMart at 3 months, 1 year, and 2 years were 17, 18, and 11 dB, respectively. The mean difference in ABG for the SMart 360° at 3 months, 1 year, and 2 years were 20, 20, and 19 dB. ABG differences at 3 months (p = 0.10) and 1 year (p = 0.36) were not statistically different. The failure rate for the SMart prosthesis was 12.5% and for the SMart 360° 2.2% (p = 0.002).

Conclusions: There were no statistically significant differences in ABG changes for SMart compared to SMart 360°. The Smart 360 corrects the problem with early failure seen with the Smart prosthesis.

Professional Practice Gap And Educational Need: Determination of most efficacious stapes prosthesis.

Learning Objective: Which stapes prosthesis produces better hearing results with fewer failures.

Desired Result: To disseminate information necessary to choose the best stapes prosthesis for patients.

Level Of Evidence: Level III.

Indicate Irb Or Iacuc: 2022-029-agh.