Long-term stapedectomy results with the McGee stapes prosthesis

Objective. To report long-term follow up on patients undergoing stapedectom y with the McGee stapes prosthesis. Study Design: A retrospective case seri es. Methods: Charts recording 170 stapedectomiies (120 primary and 50 revis ion stapedectomies) from 1989 to 1999 were analyzed, and audiometric data a nd the findings at repeat exploration reported. Results: Over a 10-year per iod, 11.2% of patients had failure of their initial air-bone gap closure wi th the McGee piston. Seventy-seven percent (in 10 of 13 patients) of McGee pistons that failed were found to have the platinum ribbon displaced latera lly from the incus and the piston pushed out of the stapedotomy. The failur e rate was not significantly different (P = .72) from that in our patients who underwent placement of a Robinson cup prosthesis (9.5%), but the patter n of displacement was unique. Failures occurred earlier with the McGee pist on (average time to failure of 2.5 y) than with the Robinson cup (average t ime to failure of 8.6 y). Conclusion: The McGee piston was found to have a unique pattern of dislocation that is likely related to the malleable natur e of the platinum ribbon and loosening of the crimped "shepherd's crook" ov er time.