Objective. To visually compare the Nitinol “smart” stapes prosthesis to conventional manual crimping stapes pistons in temporal bone cadaver specimens. Main Outcome Measures. 10 otolaryngologists were given a photograph of the randomly ordered stapes pistons and asked to use the pictures to answer questions about each stapes piston. The answers to the survey were then recorded for analysis. Results. 8 of 9 Nitinol pistons were described as circular, and 3 of 9 manual crimped pistons were described as circular (P 66% of the incus and 3 of 9 to be in contact with 34–66% of the incus. 3 of 9 manually crimped pistons were considered to be in contact with >66% of the incus, 3 with 34–66% contact and 3 with less than 34% contact. Conclusions. The Nitinol “smart” stapes pistons were considered to provide a more circular and circumferential crimping and to have greater contact with the long process of the incus than conventional stapes pistons.
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Olympus, formerly Gyrus, has been committed to stapes prostheses since 1956. We have maintained our commitment to research and development in response to surgeons’ interest in continually improved clinical outcome and products.
Hearing results using the SMart piston prosthesis.
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Use of the “smart” self-crimping shape-memory Nitinol stapes piston eliminates some of the drawbacks of manual crimping in stapedotomy and provides a technical simplification of the stapedotomy procedure in patients with otosclerosis. This should reduce stapes prosthesis loosening, displacement and incus erosion and allow for more reliable and consistent hearing results.
Otolaryngology (Ear, Nose & Throat)
The SMart prosthesis is one of the newer stapes prostheses available on the market, and a number of large series have shown good surgical outcomes with its usage [, ]. The piston exhibits shape memory whereby the application of heat leads to a phase alteration in the atomic structure resulting in the formation of a predetermined shape. In the case of a SMart prosthesis, this results in the crimping of the hook around the incus. As this crimping occurs, increased contact with the incus generates stress which acts to inhibit the memory properties and therefore stop the crimping process . This should produce a snugly fitted secure prosthesis.
01/05/2012 · Is there a “best” stapes prosthesis
Using temporal bone cadaver specimens from the Madigan Army Medical Center temporal bone bank, 10 left and 10 right temporal bone specimens were randomly selected. All specimens had previously had a mastoidectomy with facial recess preformed. All specimens then underwent stapedectomy as described below. A traditional titanium manual-crimping piston was placed in 5 left and 5 right temporal bone specimens. A Nitinol shape-memory stapes prosthesis was placed in 5 left and 5 right temporal bone specimens. All of the key portions of the procedure were performed by senior author JVC in the ENT temporal bone lab equipped with a standard McGee stapes crimper, a microdrill and KTP laser.
306 receiving a SMart prosthesis and 110 receiving a self ..
SMart Piston technology incorporates the self-crimping Nitinol memory metal alloy, which dramatically simplifies crimping in middle ear surgery.