Short- and long-term results after stapes surgery for otosclerosis with a teflon-wire piston prosthesis

The authors analyzed the results of 604 cases of primary stapes surgery performed between 1974 and 1997 with replacement of the stapes by a 0.6 or 0.8 mm Schuknecht Teflon-wire piston. At long term (one to 21 years; mean, seven years), the residual air-bone gap was less than or equal to 10 dB in 78.9% of cases. Hearing results and postoperative complications were comparable to those reported by authors who used the same evaluation criteria. Although the aim of the surgery was to perform a small stapedotomy with a narrow footplate perforation (0.8 mm), a large stapedotomy or a stapedectomy was performed in some cases due to surgical or anatomical conditions. These results show that the larger footplate perforations allowed better correction of the air-bone gap in the lower frequencies. The larger sizes of perforations did not show a higher incidence of complications.