Middle Ear Risk Index (Meri) As a Prognostic Factor in Tympanoplasty in Chronic Otitis Media

Abstract

INTRODUCTION

Otitis media is an important and a highly prevalent disease of the middle ear and poses health problem world wide especially in developing countries where large percentage of the population lack specialized medical care. With a large number of patients frequently undergoing tympanoplasty for tubotympanic type of COM, it’s important to assess the severity of the disease and predict the outcome of the surgical management whenever done.

MERI score is a prognostic tool to predict the outcome of tympanoplasty. It has an inverse relation with graft uptake and hearing benefit.

OBJECTIVES

• To assess the MERI score and tympanoplasty outcomes in cases of mild disease (1-3) .


• To evaluate the surgical outcome of tubotympanic type of chronic otitis media and its relationship to the MERI.

MATERIALS & METHODS

A prospective study was done where, 50 patients with chronic suppurative otitis media – mucosal type, with conductive hearing loss were included in this study for a period of 8 months. All the patients had a score of 1-3 which is the mild category according to MERI SCORE. The age range of patients was from 20 to 45 years.

Patients with sensorineural hearing loss, or hearing loss due to other causes were excluded,

Patients having other comorbidities like diabetes mellitus, hypertension, bronchial asthma, or thyroid disorders were excluded.

Routine blood investigations was done for all patients. Otoscopic findings of tympanic membrane perforation features in terms of size and site was noted.                                              Pure tone audiometry was done preoperatively. All patients underwent tympanoplasty surgery under general anesthesia. In this study, the underlay technique was used for surgery and temporalis fascia was used as graft material in all patients. The patient was evaluated postoperatively clinically in 2nd week and after 1-month,  3rd month follow-up visit pure tone audiometry was repeated

RESULT: Patients with a mild score of 1-3 according to the middle ear risk index was seen to have significant improvement in hearing post-operatively.

CONCLUSION: MERI score is a useful tool for accessing the success rate of tympanoplasty.