A Prospective Study to Evaluate Role of Middle Ear Risk Index in Tympanoplasty with Mastoidectomy as a Prognostic Parameter

Archana Mathri, Niya Joseph Neelamkavi
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Abstract

Abstract Introduction Chronic otitis media (COM) is an otological challenge in the developing countries as it is a persistent disease causing severe destruction of middle ear with irreversible sequalae. To assess Middle Ear Risk Index (MERI) score and study its prognostic effect in postoperative outcome following mastoidectomy with tympanoplasty. To evaluate MERI score with respect to graft uptake and A-B gap closure. Materials and Methods This prospective study comprised 25 patients suffering from COM who presented to the Department of ENT, HSK Hospital, Bagalkot, over a period of 1 year from November 2020 to November 2021. The patients underwent tympanoplasty with mastoidectomy. MERI 2001 was used in the current study, and risk factors were assessed based on pre- and intra-operative findings to obtain the MERI score. Patients were segregated into those with mild (1–3), moderate (4–7), and severe (8–15) MERI. They were evaluated at 1 month follow-up visit. Results and Conclusion The study reveals the degree to which MERI score can predict the extent of disease and indicate outcome of surgery. In the present study, patients with lower MERI score benefitted more favorably in terms of graft uptake and hearing improvement as compared with success rate of severe MERI score. MERI index is in fact a very reliable predictor of graft uptake and audiological alteration in patients undergoing tympanoplasty with mastoidectomy surgeries for COM.
一项评估中耳风险指数在鼓室成形术合并乳突切除术中作为预后参数作用的前瞻性研究
慢性中耳炎(COM)是发展中国家的一个耳科学挑战,因为它是一种导致中耳严重破坏并伴有不可逆后遗症的持续性疾病。目的评估中耳风险指数(MERI)评分,探讨其对乳突切除合并鼓室成形术患者术后预后的影响。评价MERI评分与移植物摄取和A-B间隙闭合的关系。材料与方法本前瞻性研究纳入了从2020年11月至2021年11月1年期间在巴加尔科特HSK医院耳鼻喉科就诊的25例COM患者。患者行鼓室成形术合并乳突切除术。本研究使用MERI 2001,并根据术前和术中发现评估危险因素以获得MERI评分。患者被分为轻度(1-3)、中度(4-7)和重度(8-15)MERI。随访1个月后进行评估。结果与结论本研究揭示了MERI评分在一定程度上可以预测疾病的程度和指示手术结果。在本研究中,较低MERI评分的患者在移植物摄取和听力改善方面比重度MERI评分的患者更有利。事实上,MERI指数是一个非常可靠的预测鼻咽癌患者接受鼓室成形术和乳突切除术后移植物摄取和听力学改变的指标。
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