STAPEDOTOMY WITH IMPLANTATION OF THE FISCH-TYPE 0,4 mm TITANIUM STAPES PROSTHESIS, A GOOD ALTERNATIVE IN STAPES SURGERY

The aim of this short-term result study was to present our experience with the Fisch-type 0,4 mm titanium prosthesis we use in stapes surgery.We retrospectively analyzed the postoperative hearing results obtained in 162 stapes operations with implantation of the Fisch-type 0.4 mm titanium piston. We compared them with the hearing results obtained with two types of prostheses we used before we introduced the titanium piston (49 stapes operation with implantation of the Causse-type Teflon pistons with a diameter of 0.6 mm and 45 stapes operations with implantation of the Fisch-type Teflon and stainless steel pistons with a diameter of 0,4 mm). In the majority of patients, a stapedotomy technique was performed. Only in 14 cases, the stapes footplate was removed. Pure-tone audiometry with appropriate masking was performed approximately six weeks postoperatively. The average postoperative ABG was calculated as the postoperative air PTA minus the postoperative bone PTA.Although the functional results of the three different types of stapes prosthesis did not vary significantly, the Fisch-type 0.4 mm titanium piston gave a somewhat better result in closing the ABG in the “within 10 dB” range. This may be due to a better fixation of the prosthesis to the long process of the incus.The good characteristics of the titanium piston made it our first choice in stapes surgery, gradually replacing the other two types of stapes prostheses.