Explore this issue:June 2014
The surgical approach to otosclerosis has evolved significantly over the decades following Shea’s first stapedectomy in 1956. The procedure has progressed from total removal of the stapes footplate, to partial stapedectomy, and now to small fenestra stapedotomy using a microdrill or laser. Likewise, the choice of stapes prosthesis has changed over the years in terms of size, shape, and composition. The three most common prosthesis designs are the wire loop, piston, and bucket handle, although there are many variations on each. Piston diameter has ranged from 0.3 to 0.8 mm. Prostheses have been made from a wide array of materials including Teflon, stainless steel, platinum, gold, and more recently a nickel titanium alloy, nitinol.