Comparison of Wire-Vein and Wire-Gelfoam Prostheses in Stapedectomy for Otosclerosis

Abstract

A comparison was made of the overall postoperative results for a group of 50 patients who had undergone a wire-gelfoam stapedectomy procedure for otosclerosis and a group of 106 patients who had undergone a wire-vein graft procedure. All operations were performed by the same surgeon and all testing was conducted in sound treated rooms by experienced audiologists using calibrated equipment. The results for the wire-vein group were consistently superior. At the four-month postoperative test date, air-bone closure for the wire-vein group was better at all frequencies by approximately 2 to 4 dB. Also, the four-month postoperative speech discrimination scores showed a decrement of only 1.8% for the wire-vein group in contrast to a decrement of 5.9% for the wire-gelfoam group. Furthermore, while no serious postoperative complications occurred for the wire-vein group, two instances of fistulae and one instance of wire migration occurred for the wire-gelfoam group. These results, coupled with recently proved long-term stability for the wire-vein graft prosthesis, support our initial clinical impression favoring the wire-vein graft stapedectomy procedure.