Polyethylene or Wire?
Polyethylene and wire (stainless steel or tantalum) are well tolerated in the middle ear. We are indebted to Shea1 and Schuknecht2 for introducing these 2 types of prostheses. I have had the opportunity of using both techniques since their introduction.Polyethylene Problem Cases.—Wire is more adaptable than polyethylene if the incus is short, long, or necrotic (Fig. 1). This is true also in cases with a narrow oval window niche due to a large facial dehiscence or a promontory otosclerotic overhang. Removal of this overhang by the drill occasionally activates the otosclerosis. Wire can often be used without the drilling required to create room for polyethylene.Polyethylene Strut Slippage.—The standard polyethylene strut may spontaneously detach from the incus.3,4 This complication (Fig. 2) has occurred as long as 2 years after surgery and is usually associated with pressure changes.The slipped strut may perforate the oval window membrane
HOUSE HP. The Prefabricated Wire Loop-GelfoamStapedectomy. Arch Otolaryngol. 1962;76(4):298–302. doi:10.1001/archotol.1962.00740050308004