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Conclusion: Despite the limited number of patients, this preliminary study Conclusion: When considering the limited experience, the NiTiFLEX Sta-
demonstrates the effectiveness of the angular clip prosthesis in recon- pes Prosthesis is a promising development of the (Soft) Clip technique. The
structing the ossicular chain. In cases of a normal aeration of the tympanic audiological results of the small series of cases are very satisfactory and
cavity, this reliable reconstruction of the biological chain offers a near-to- comparable with other prostheses. However, long-term results with a great-
normal hearing restoration. er number of cases are still necessary.

Initial experience with the NiTiFLEX Stapes Prosthesis
®
REGENSBURG TYPE T O TAL PROS THESIS at the ENT Hospital Erlangen
Brase C., Pohmer S., Stockmayer N., lro H., Hornung J.
A Micro-Computed Tomographic Study: Determination of the
Angle Between the Tympanic Membrane and Stapes Footplate Published: 86th Annual Meeting of the German Society for Oto- Rhino-
in a Total Ossicular Reconstruction Prosthesis Reconstruction Laryngology, Head and Neck Surgery. Berlin, May 13-16, 2015. (German)
DOI: 10.3205/15hnod316
Herkenhoff S., Fischer B., Gleich O., Strutz J., Kwok P.
Introduction: One of the most important steps in stapes surgery is fixing
Published: Otol Neurotol. 2011 Jun;32(4):610-5. the stapes prosthesis to the long process of the incus. In recent times great
DOI: 10.1097/MAO.0b013e318213af4d efforts have been made to simplify this step with “self-fixing” prostheses.
This paper reports on our initial experience with the Kurz NiTiFLEX Stapes
Objectives: To examine the anatomical relationship of the angles between Prosthesis.
tympanic membrane and stapes footplate and the variation of these angles
among different temporal bones in order to characterize the optimal shape Material and Methods: A total of 16 NiTiFLEX prostheses was implanted
of total ossicular reconstruction prostheses (TORPs). between 8/2014 and 11/2014. All operations were performed under full an-
esthesia. The preoperative air-bone gap at 0.5, 1, 2 and 4 kHz was compared
Methods: Ten specimens of human temporal bones were prepared for with the postoperative air-bone gap after an average of one month and after
examination with microcomputed tomography. Five of the 10 temporal about 3 months.
bones were implanted with 3 types of TORPs before subjecting them to
micro-computed mography. The angles between tympanic membrane Results: During the operation it was shown that the prosthesis was not well
and stapes footplate were determined. The contact of the TORPs to these attached to all processes of the incus. In three cases the prosthesis could
structures was assessed. not be fixed during the operation due to the thickness of the process of the
incus and had to be removed. The audiological results for the patients in
Results: The angle between the stapes footplate and the tympanic mem- whom the prosthesis could be fixed were comparable with those of other
brane was, on average, 25.9 degrees in a plane along the transverse axis of self-fixing prostheses.
the stapes footplate and 24.6 degrees in a plane along the longitudinal axis
of the stapes footplate. Consideration of these angles in TORPs resulted in Conclusion: The NiTiFLEX Stapes Prosthesis can be fixed without diffi-
an optimal contact with the tympanic membrane and stapes footplate, espe- culties to normally shaped processes of the incus and yields good postop-
cially for theses with a large foot. erative audiological results. As a development of the well-known SoftClip
prosthesis with superelastic material, the NiTiFLEX prosthesis should be
Conclusion: TORPs should be adjusted in shape before insertion into the suitable for a wide range of processes of the incus. However, due to the
middle ear. Further developments should consider prostheses with pread- relatively small prosthesis eyelet, it cannot be used for every anatomical
justed angles or appliances for the exact modification of the prostheses variation of the long process of the incus.
during surgery.

MATRIX
NITIFLEX
Initial experiences with the Matrix Type Stapes Prosthesis
®
Initial experience with the NiTiFLEX Stapes Prosthesis
Rösch S., Moser G., Töth M., Rasp G.
Zirkler J., Rahne T., Plontke S.
Published: Austrian Annual Meeting of ENT, 2015. Poster Abstract (German)
Published: 86th Annual Meeting of the German Society for Oto-, Rhino-, Lar- DOI:10.1097/MAO. 0b013e3182a43619
yngology, Head and Neck Surgery. Berlin, May 13-16, 2015. Poster Abstract
(German) DOI: 10.3205/15hnod534 Introduction and Question: A new prosthesis joined the wide range of
prostheses available for stapedioplasty about two years ago, the Kurz Matrix
Introduction: The attachment to the long process of the incus is the most Type. This report describes our initial experience with this prosthesis with the
important part of stapes surgery. We report here on our initial experience postoperative audiology results and the handling during the operation.
with the new NiTiFLEX Stapes Prosthesis, a development of the Soft
CliP® Stapes Prosthesis (Kurz). The clip is now made of nitinol, a nickel- Method: Retrospective data analysis using the ENTstatistics Digital database.
titanium alloy. The contact pressure on the long process of the incus has
been further reduced and the attachment to the long process of the incus Results: A total of 22 patients received the Kurz Matrix Type Stapes Pros-
should be simplified. theses on one side (n=22) during a primary stapes operation from Septem-
ber 2014 to May 2015. A test of the 0.5, 1.0, 2.0 and 4.0 kHz frequencies
Method: A stapedioplasty was done in 11 patients (6f, 5m) (a revision showed an average improvement of the air-bone gap of approximately
operation).The average age of the patients was 45 years. The footplate was 15 dB. The postoperative follow-up for all patients was less than 12 months.
perforated by a CO2 laser (scanning mode).
Discussion/Conclusion: The initial analysis of the experience with the
Results: The NiTiFLEX Stapes Prosthesis could be placed in all patients Matrix Type Stapes Prosthesis at our hospital appears to lead to good results
without complications. There was no significant change in bone conduc- in improving hearing. In particular, the handling of the prosthesis during the
tion after the operation. The sound conduction gap could be satisfactorily operation is satisfactory for the surgeon. The new design of the loop with a
reduced in all patients. (4PTA 0.5-4 preoperative on average 23.6, postopera- wider and perforated surface and the spiral shape seems to improve the crimp-
tive 6.3 dB). We considered the handling of the prosthesis to be very good. ing procedure in particular and the subsequent seating of the prosthesis on

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