Effect of Middle Ear Prosthesis Diameter in Platinotomy and Partial Platinectomy on Hearing Gain: A Finite Element Study

This study investigates, for the first time, using finite element analysis (FEA), the differential impact of middle ear prosthesis diameter on hearing gain in two distinct surgical techniques: stapedotomy and partial stapedectomy. The model represented the cochlea as two fluid-filled straight channels separated by the basilar membrane and considered pistons of 0.4 mm and 0.6 mm diameters. The results demonstrated that in stapedotomy, a 0.6 mm diameter piston yielded a significantly better reduction in ABG (8.31 dB) compared to the 0.4 mm piston (10.67 dB), indicating improved hearing gain. Conversely, in partial stapedectomy, the smaller 0.4 mm piston was more effective, reducing ABG to 11.2 dB versus 12.12 dB with the larger piston. These findings highlight that the optimal prosthesis diameter varies according to surgical technique, emphasizing the need for tailored prosthesis selection.