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Ossiculoplasty and Stapedioplasty with Titanium Prostheses

Stapes prostheses are available in a wide range of clinical materials. Utilising Nitinol, the SMart Piston and SMart De La Cruz Piston features self-crimping and a self-measuring body for enhanced surgical precision. Micron Titanium being a different material provides an extremely smooth finish with high visibility.

current Trends in Middle Ear Surgery Ossiculoplasty And Stapedioplasty With Titanium Prostheses

All these things take their toll on the long-term results. Even in the best hands, less than 50% achieve socially acceptable hearing from ossiculoplasty. If the stapes (the third and most delicate bone in the chain) has been damaged, the prospects of restoring useful hearing by ossiculoplasty are very poor indeed. Many UK ear surgeons won’t even attempt ossiculoplasty, since the chances of success are low, and there are significant risks of damaging the inner ear permanently by manipulating the ossicular chain in the attempt to rebuild it. My own view is that it is reasonable to attempt ossiculoplasty, if the situation on the table looks favourable. If the ossiculoplasty fails to give satisfactory hearing, we have the BAHA (Bone Anchored Hearing Aid – osseointegrated titanium auditory implant) to fall back upon.

Patent US7288113 - Titanium incudo-stapedial joint prosthesis

Note that only Kurz currently has a pure-titanium stapes prosthesis.

Work in developing superior implant materials was continued until the 1970’s, when bioactive materials were developed. Their name comes from their chemical structure, which promotes chemical adhesion between the tissue and the implant, effectively eliminating the need for Auto- and Homo- Grafts.

From 1970 to up till now, various types of material have been using for ossicular chain reconstruction like as Gold, Stainless Steel, Platinum, Hydroxyapatite, Teflon, Polyethylene, Glass Ionomer Cement, and Titanium.

But recently the new trend starts to perform surgery of Ossiculoplasty, Stapedioplasty, and Myringoplasty with based Middle ear` implants. Titanium implants are extensively used in cardiovascular, spinal surgery, orthopedic and dental surgery as well as in reconstructive and plastic surgery.






AB - OBJECTIVE: Physicians and patients alike have concerns regarding exposing in vivo implanted metal stapes prostheses to magnetic resonance imaging (MRI) scanners. As MRI scanners become more powerful, the possibility for stapes prosthesis displacement due to ferromagnetic forces increases. It is hypothesized that some metal stapes prostheses may be exposed to powerful MRI scanners without leading to potential adversities for patients. STUDY DESIGN: Literature review, retrospective case review, and physician survey. SETTINGS: Tertiary care, University Medical Center. MATERIALS AND METHODS: A review of the medical literature,a retrospective case review, and a clinical survey were performed. RESULTS: In the history of stapes prostheses, 1 adverse patient outcome was causally substantiated when a defective stapes prosthesis was exposed to an MRI field. Otherwise, a review of the literature on experiments investigating stapes prostheses and MRI fields revealed a lack of any adverse clinical reports. In addition, 2 physician's surveys revealed no other cases of symptoms or damage to the ears of patients with stapes prostheses that had been exposed to an MRI scanner. CONCLUSION: All patients with a metallic stapes prosthesis may be sent to the MRI scanner, with the exception of 1 specific defective prosthesis type. The exception is a 1987 accidental mismanufacture of several lots of McGee pistons with a magnetic alloy. Patients with these specifically identified lots of McGee pistons should go to a computed tomographic scanner or be reimplanted with another prosthesis if MRI scans are mandatory. It would be advisable for manufacturers to use nonferromagnetic metals such as titanium for production of future stapes prostheses.

MRI scanners and the stapes prosthesis

Comparison of two stapes prostheses (titanium ..

The SMart De La Cruz Piston facilitates stapes surgery with its self-measuring body, improving the ability to measure implant length accurately. It is compatible for MRI up to 3 Tesla.

Biocompatible materials most frequently employed in pistons are stainless-steel, fluoroplastic (Teflon-type polymer) and platinum, although a new titanium prosthesis has recently become available (2).

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TheList_search - MRI Safety Home

N2 - OBJECTIVE: Physicians and patients alike have concerns regarding exposing in vivo implanted metal stapes prostheses to magnetic resonance imaging (MRI) scanners. As MRI scanners become more powerful, the possibility for stapes prosthesis displacement due to ferromagnetic forces increases. It is hypothesized that some metal stapes prostheses may be exposed to powerful MRI scanners without leading to potential adversities for patients. STUDY DESIGN: Literature review, retrospective case review, and physician survey. SETTINGS: Tertiary care, University Medical Center. MATERIALS AND METHODS: A review of the medical literature,a retrospective case review, and a clinical survey were performed. RESULTS: In the history of stapes prostheses, 1 adverse patient outcome was causally substantiated when a defective stapes prosthesis was exposed to an MRI field. Otherwise, a review of the literature on experiments investigating stapes prostheses and MRI fields revealed a lack of any adverse clinical reports. In addition, 2 physician's surveys revealed no other cases of symptoms or damage to the ears of patients with stapes prostheses that had been exposed to an MRI scanner. CONCLUSION: All patients with a metallic stapes prosthesis may be sent to the MRI scanner, with the exception of 1 specific defective prosthesis type. The exception is a 1987 accidental mismanufacture of several lots of McGee pistons with a magnetic alloy. Patients with these specifically identified lots of McGee pistons should go to a computed tomographic scanner or be reimplanted with another prosthesis if MRI scans are mandatory. It would be advisable for manufacturers to use nonferromagnetic metals such as titanium for production of future stapes prostheses.

Stapes Prostheses - Products - Grace Medical

OBJECTIVE: Physicians and patients alike have concerns regarding exposing in vivo implanted metal stapes prostheses to magnetic resonance imaging (MRI) scanners. As MRI scanners become more powerful, the possibility for stapes prosthesis displacement due to ferromagnetic forces increases. It is hypothesized that some metal stapes prostheses may be exposed to powerful MRI scanners without leading to potential adversities for patients. STUDY DESIGN: Literature review, retrospective case review, and physician survey. SETTINGS: Tertiary care, University Medical Center. MATERIALS AND METHODS: A review of the medical literature,a retrospective case review, and a clinical survey were performed. RESULTS: In the history of stapes prostheses, 1 adverse patient outcome was causally substantiated when a defective stapes prosthesis was exposed to an MRI field. Otherwise, a review of the literature on experiments investigating stapes prostheses and MRI fields revealed a lack of any adverse clinical reports. In addition, 2 physician's surveys revealed no other cases of symptoms or damage to the ears of patients with stapes prostheses that had been exposed to an MRI scanner. CONCLUSION: All patients with a metallic stapes prosthesis may be sent to the MRI scanner, with the exception of 1 specific defective prosthesis type. The exception is a 1987 accidental mismanufacture of several lots of McGee pistons with a magnetic alloy. Patients with these specifically identified lots of McGee pistons should go to a computed tomographic scanner or be reimplanted with another prosthesis if MRI scans are mandatory. It would be advisable for manufacturers to use nonferromagnetic metals such as titanium for production of future stapes prostheses.

Stapes Prostheses - Stapes Prostheses - Grace Medical

There are also some devices called "active implants". These devices are technologically more advanced than the passive devices above. Most of them are not yet available in the United states.

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