A retrospective study on middle ear risk indices in analysing the postoperative outcome following tympanoplasty

Abstract

<p class="abstract"><strong>Background:</strong> Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem worldwide especially in developing countries where large percentage of the population lack specialized medical care. A normally functioning eustachian tube is an equally essential physiologic requirement for a healthy middle ear and normal hearing. In this study we have used the middle ear risk index (MERI) developed by Kartush which generates a numeric indicator of the severity of the middle ear disease to stratify patient groups according to the severity of the disease and to evaluate the efficiency of MERI score in predicting the outcome of tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> Patients who came and got operated for tympanoplasty to the ENT Department in Konaseema Institute of Medical Sciences and RF, Amalapuram during the study period of February 2017 to February 2018. </p><p class="abstract"><strong>Results:</strong> In this study graft was accepted in 22 patients (88%) and rejected in 3 (12%) patients. In patients in the mild MERI risk group n=22, graft was accepted in 21 (95%) patients and rejected in 1 patient (5%). Patient had a residual perforation. In patients in the moderate MERI risk group n=2, graft was accepted in 1 (50%) patients and rejected in 1 patient (50%).In severe risk group none of the grafts were accepted (100%).</p><p><strong>Conclusions:</strong> MERI index is in fact a very useful and honest predictor of the graft uptake and audiological gain in patients undergoing tympanoplasty surgeries for CSOM. Lower the MERI index better the outcome. Positive Belluci criteria were also found to be inversely associated with the graft uptake.</p>

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

“…AB gap less than 10 dB was considered as successful. 3 Accordingly, in the mild MERI risk group n = 14, 11 patients were successful, 3 patients had improvement, and none of these patients failed. In the moderate MERI risk group n = 6, five patients were successful.…”

“…2 The main aim of surgery for COM is to remove the disease, make the ear dry and to restore hearing. 3 Tympanomastoidectomy is the procedure for removal of the disease from the middle ear cleft done either as open or closed cavity procedure, and tympanoplasty is the procedure for reconstruction of the middle ear. 3…”

Predictors of anatomical and functional outcomes following tympanoplasty: A retrospective study of 413 procedures

“…Previous studies showed that patients without otorrhea could have a better hearing threshold after tympanoplasty. 24 Vignadutt et al 25 have reported that dry ears were more associated with graft success. However, Gamra et al 26 found no significant difference for graft success and hearing gain between dry and wet ears.…”

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

“…4,8 However some studies showed that there are more likely chances of graft rejection in persistently wet ears. 15 The effect of smoking on the middle ear can be classified as local (due to effect on mucociliary apparatus), regional (due to Eustachian tube obstruction) or systemic (due to immunosupression). 8 A study conducted to review the effects of smoking on the success rate of tympanoplasty revealed that smoking was associated with a threefold increase in chance of long-term failure of graft.…”

“…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).…”