Effectiveness of the Heat-Activated Nitinol SMart Piston Stapes Prosthesis in Stapedectomy Surgery

Objective: To compare the SMart piston stapes prosthesis to a standard manual crimp prosthesis on operative time and air-bone gap (ABG) closure in stapedectomy. Design: Retrospective chart review. Setting: Tertiary referral centre. Methods: The charts of patients undergoing stapedectomy for otosclerosis were analyzed. We compared the results of 76 patients (80 ears) who received the autocrimping SMart piston prosthesis to those of 21 patients (21 ears) who received the conventional manual crimp Fisch-type prosthesis. Data were analyzed using t-test, chi-square, or two-way analysis of variance where appropriate. Main Outcome Measure: Operative time with ABG closure as a secondary outcome measure. Results: There was a significant difference in operative time between the Fisch-type prosthesis and the SMart piston prosthesis groups. The operation required 28.9 +/- 3.2 minutes when using the Fisch-type prosthesis, whereas 21.2 +/- 2.4 minutes were needed when using the SMart piston (p < .001). There was a significant improvement in postoperative ABG for both the Fisch-type piston (28.1 +/- 3.1 to 9.0 +/- 1.4, p < .001) and the SMart piston (25.1 +/- 3.7 to 8.2 +/- 2.5, p < .001) groups. Conclusions: Use of the SMart piston prosthesis results in ABG closure similar to that of the traditional Fisch-type prosthesis but offers the added advantage of reduced operative time.