Enhanced hearing in heat-activated-crimping prosthesis stapedectomy.

Objectives: Compare short-term hearing outcomes with a heat-activated-crimping versus manual-crimping stapedectomy prosthesis.

Study Design: Retrospective chart review.

Setting: Tertiary care neurotology referral center.

Patients: 219 charts reviewed.

Intervention: Laser stapedectomy.

Main Outcome Measures: Audiometric.

Methods: Retrospective study comparing postoperative hearing in manual-crimp prostheses stapedectomies versus heat-activated-crimp prostheses stapedectomies.

Results: Of the 219 patients reviewed, 94 met inclusion criteria for the study, with 47 receiving manual-crimp prosthesis and 47 receiving heat-activated-crimp prosthesis. Short-term poststapedectomy air-bone gaps, long-term air-bone gaps, long-term pure-tone averages, and long-term air-bone gap closures were significantly better for heat-activated-crimp versus manual-crimp prostheses.

Conclusion: Heat-activated-crimping prostheses demonstrated enhanced stapedectomy hearing outcomes versus manual-crimping prostheses on short- and long-term follow-up. Three-dimensional reorientation of the heat-activated prosthesis may enhance the hearing outcome; however, theoretical nickel allergy considerations, effects of case selection, follow-up duration, possible eventual loosening of the heat-activated crimp, and long-term incus necrosis are considerations requiring continued longitudinal analysis.