A Prospective Study on Middle Ear Risk Index (MERI) and Outcome of Tympanoplasty with a Note on quality-of-Life (QOL)

Nallapaneni, Lakshmi Shree; Sudarsan, Shyam Sudhakar; Krishnamoorthy, Srinivasan

doi:10.1007/s12070-020-01796-y

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…11 There was a female preponderance in our study which was also noted in some of the studies. 12,13 A vast majority of our patients fell into MERI mild category (74%) with no patients in severe category. These results were similar to previous studies which showed that mild category of MERI was a majority.…”

Section: Discussionmentioning

confidence: 86%

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A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty

Risvana

2021

Int J Otorhinolaryngol Head Neck Surg

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Background: Chronic otitis media is a highly prevalent disease of middle ear. As tympanoplasty plays an important role in management of otitis media it is important to predict the outcome of surgery and give proper counselling to the patient. The objective of this study was to evaluate the effectiveness of Middle ear risk index (MERI) in determining postoperative graft uptake and postoperative air bone gap closure following tympanoplasty.Methods: This was a retrospective study conducted to find the correlation between MERI and the result of tympanoplasty outcome and post-operative hearing gain. Ninety-six subjects who underwent tympanoplasty for chronic otitis media were included in the study. MERI score was calculated and was compared with postoperative graft uptake and audiogram. Results: In this study there was no statistical difference in graft uptake between the MERI categories. There was statistically significant decrease in postoperative air bone gap closure in both mild and moderate categories. Other prognostic factors associated with a favourable outcome were healthy middle ear mucosa and absence of smoking.Conclusions: MERI did not have a direct impact on the outcome of surgery in terms of graft uptake and hearing results. However certain factors like Belluci’s criteria and smoking had an impact on the outcome. Hence MERI can be used for pre-operative counselling of the patients.

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Section: Discussionmentioning

confidence: 86%

“…Tympanic membrane status of operated ear at the end of one month was obtained from case records and postoperative audiogram at the end of 3 months was obtained from audiology database maintained by the department audiologist. Note: M-malleus, S-stapes suprastructure, mild (1-3), moderate (4)(5)(6) and severe (7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty

Risvana

2021

Int J Otorhinolaryngol Head Neck Surg

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“…There seemed to be no universally accepted predictor. Numerous variables had been studied, including age [ 8 , 19 ], audiometric results [ 8 ], absence of craniofacial dysmorphia [ 19 ], state of contralateral ear [ 19 ], state of otorrhea and infection [ 20 , 21 ], previous adenoidectomy [ 19 ], cause of perforation [ 19 ], size of perforation [ 8 , 19 ], state of middle-ear mucosa [ 8 , 19 , 20 ], residual ossicular remnants [ 22 – 24 ], allergy [ 25 – 28 ], and Eustachian tube function [ 6 , 20 , 25 ]. In the available literature, it is difficult to find a report quantitatively predicting frequency-specific air-conduction threshold after tympanoplasty.…”

Section: Discussionmentioning

confidence: 99%

“…Improving hearing is one goal of tympanoplasty [3][4][5], in addition to removing the underlying disease [5] and producing a safe dry ear [5]. It would be helpful if ear surgeons can predict the outcome of postoperative hearing and give proper counseling for the patient, to avoid untoward expectations [6].…”

Section: Introductionmentioning

confidence: 99%

“…However, it is difficult to predict postoperative hearing outcome without knowing the disease process in the middle ear, which can only be assessed intraoperatively [ 5 ]. Studies usually reported only qualitative hearing comparisons, e.g., the better outcome in two groups [ 6 ] or improvement vs. deterioration after the surgery [ 8 ]. Higashimachi et al built a predicting model comparing the frequency response vs. stapes-footplate displacement between COM patients and normal-hearing individuals [ 9 ], without an associated report predicting real hearing outcome.…”

Section: Introductionmentioning

confidence: 99%

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Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty

Huang

Chuang

et al. 2021

PLoS ONE

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Postoperative hearing improvement is one of the main expectations for patients receiving tympanoplasty. The capacity to predict postoperative hearing may help to counsel a patient properly and avoid untoward expectations. It is difficult to predict postoperative hearing without knowing the disease process in the middle ear, which can only be assessed intraoperatively. However, the duration and extent of the underlying pathologies may represent in bone-conduction threshold and air-bone gap. Here in patients undergoing tympanoplasty without ossiculoplasty, we sorted and separated the surgery dates into the first group to build the predicting models and the second group to test the predictions. There were 87 and 30 ears, respectively. No specific enrollment or exclusion criteria were based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions. The results show that bone-conduction threshold and air-bone gap together predicted air-conduction threshold after the surgery, including each frequency of 0.5k, 1k, 2k, and 4k Hz. The discrepancies between the predictions and recordings did not differ among these four frequencies. Of the variance in mean postoperative air-conduction threshold, 56.7% was linearly accounted for by these two preoperative predictors in this sample. The results suggest a trend that, the higher the frequency, the larger the part was accounted for by these two preoperative predictors. These together may help a surgeon to estimate frequency-specific hearing outcome after the surgery, answer patients’ questions with quantitative statistics, and counsel patients with proper expectations.

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Unveiling the Aggressiveness of Cholesteatoma: Associating MERI with miRNA‐21 & IL‐6 Expression

Mohan,

Purohit

et al. 2024

The Laryngoscope

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BackgroundCholesteatoma, a destructive middle ear condition, poses challenges due to its variable clinical presentation and propensity for recurrence. Understanding its molecular underpinnings could enhance prognostication and guide therapeutic interventions. This study investigates the association between cholesteatoma aggressiveness, as assessed by the Middle Ear Risk Index (MERI), and the expression of miRNA‐21 and IL‐6 genes.MethodsA cross‐sectional observational study involving 30 patients with cholesteatoma undergoing tympanomastoid exploration was conducted. MERI scores were calculated preoperatively, and cholesteatoma tissue was analyzed for miRNA‐21 and IL‐6 gene expression using RT‐PCR. Statistical analysis was performed to correlate MERI scores with gene expression levels.ResultsThe majority (80%) of patients exhibited severe MERI scores, correlating with extensive middle ear pathology and necessitating canal wall‐down (CWD) mastoidectomy. Higher miRNA‐21 and IL‐6 gene expression levels were observed in cholesteatoma tissues, indicating local aggressiveness and inflammatory activity. Significant moderate correlations were found between MERI scores and miRNA‐21 (Pearson correlation = 0.579, p = 0.001) and IL‐6 gene expression (Pearson correlation = 0.388, p = 0.034). Patients with severe MERI scores had elevated miRNA‐21 and IL‐6 levels, suggesting a more aggressive disease phenotype.ConclusionMERI scores demonstrated utility in predicting cholesteatoma aggressiveness, with higher scores correlating with elevated miRNA‐21 and IL‐6 expression. These findings suggest a potential role for MERI in guiding surgical decision‐making and prognostication. Future research on targeted therapies based on molecular mechanisms holds promise for improving cholesteatoma management.Level of Evidence3 Laryngoscope, 2024

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A Prospective Study on Middle Ear Risk Index (MERI) and Outcome of Tympanoplasty with a Note on quality-of-Life (QOL)

Cited by 10 publications

References 24 publications

A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty

A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty

Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty

Unveiling the Aggressiveness of Cholesteatoma: Associating MERI with miRNA‐21 & IL‐6 Expression

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