Stapedotomy : does titanium soft clip prostheses affect outcome?

Purpose : the aim of this study was to compare the postoperative hearing outcomes of stapes surgery with titanium soft clip stapes piston to those with Teflon in cases of otosclerosis. patients and methods : 40 patients with otosclerosis. twenty patients were operated with stapedotomy with the insertion of titanium soft clip prostheses and 20 patients were operated with the insertion of Teflon prostheses. all patients had conductive or mixed hearing loss. the mean air-bone gap (averaged across frequencies of 500, 1000, 2000 and 4000 Hz) was 28.4 dB HL ± SD of 6.3 DB HL. air-bone gap was computed postoperatively at intervals of one, three and 6 months for all patients. results : the mean postoperative air-bone gap for the teflon group was 2.7 dB HL, 1.6 dB HL, and 1.2 dB HL at one, three, and 6 months respectively. the mean postoperative air-bone gap for the titanium group was 3.4 dB hl, 4.5 dB HL, and 4.5 dB HL at one, three, and 6 months respectively. no statistically significant difference was found between the two groups as regards the preoperative or the postoperative air-bone gap at the different intervals. all patients in the two groups had air-bone gap less than 10 dB at the different follow up intervals. conclusion : titanium prosthesis provide equal hearing improvement to the Teflon prosthesis for patient with otosclerosis with the advantages of secure coupling, decreased risk of necrosis of long process of incus, easier application, and lesser surgical time but needs experience.