Middle Ear Risk Index [MERI] as Prognostic Factor in Tympanomastoidectomy with Tympanoplasty

Abstract

Aims: To evaluate a group of patients undergoing surgery for chronic otitis media with reference to the prognostic value of middle ear risk index and other factors in predicting the anatomical and functional outcome of tympanomastoidectomy with tympanoplasty. Subjects:The study comprised of 90 patients suffering from chronic otitis media with or without cholesteatoma. Patients attending the Otorhinolaryngology out patients department were considered for this study. Methods:The patients underwent tympanomastoidectomy with tympanoplasty in which mastoidectomy performed was of either canal wall up or canal wall down technique. In cholesteatoma surgery, whenever possible a canal wall up procedure was performed. Myringoplasty was done using autologous temporalis fascia graft by underlay technique. Middle ear risk index [MERI] and other factors were evaluated for their outcome predictive role in patients undergoing tympanomastoidectomy with tympanoplasty.Results: Outcomes were evaluated in terms of tympanic membrane graft uptake and post operative mean audiological gain. The Middle ear risk index was also found to be significant predictor ofthe outcome of surgery. The patients with mild MERI scores had significantly better prognosis than the patients with sever MERI scores. Conclusion:The Anatomical and Functional outcome of tympanomastoidectomy with tympanoplasty is diversely affected by the pathological and technical factors associated with disease and its management. A better understanding of these factors is helpful for better prognostication of the factors affecting the disease and in planning the surgical procedure.