A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20213281Keywords:
Chronic otitis media, Middle ear risk index, Post-operative outcome, TympanoplastyAbstract
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.
References
Pinar E, Sadullahoglu K, Calli C, Oncel S. Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngol Head Neck Surg. 2008;139(3):386-90.
Singh A, Jain RK, Agarwal U, Chaudhary AK, Singh V. Prognostic parameters and their relevance in outcome of middle ear surgeries. Indian J Otolaryngol Head Neck Surg. 2020.
Felek SA, Celik H, Islam A, Elhan AH, Demirci M, Samim E. Type 2 ossiculoplasty: prognostic determination of hearing results by middle ear risk index. Am J Otolaryngol. 2010;31(5):325-31.
Aggarwal SK, Dev R. Comparative study of tympanoplasty and its outcome in various age groups using middle ear risk index scale. Indian J Otol. 2020;26:4-8.
Kumar N, Madkikar NN, Kishve S, Chilke D, Shinde KJ. Using middle ear risk index and et function as parameters for predicting the outcome of tympanoplasty. Indian J Otolaryngol Head Neck Surg. 2012;64(1):13-6.
Almazrou K, Alqahtani M, Alshehabi M. Middle ear risk index as a prognostic factor in pediatric ossicular reconstruction. Indian J Otol. 2013;19(1):23-36.
Becvarovski Z, Kartush JM. Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI). Laryngoscope. 2001;111(10):1806-11.
Lima JC, Marone SA, Martucci O, Gonçalez F, Silva NJJ, Ramos AC. Evaluation of the organic and functional results of tympanoplasties through a retro-auricular approach at a medical residency unit. Braz J Otorhinolaryngol. 2011;77(2):229-36.
Shishegar M, Faramarzi M, Rashidi RM. Evaluation of middle ear risk index in patients undergoing tympanoplasty. Eur Arch Otorhinolaryngol. 2019;276(10):2769-74.
Merenda D, Koike K, Shafiei M, Ramadan H. Tympanometric volume: a predictor of success of tympanoplasty in children. Otolaryngol Head Neck Surg. 2007;136(2):189-92.
Sevil E, Doblan A. Significance of the middle ear risk index in predicting tympanoplasty success in the elderly. Eur Arch Otorhinolaryngol. 2020.
Nallapaneni LS, Sudarshan SS, Krishnamoorthy S. A prospective study on middle ear risk index (MERI) and outcome of tympanoplasty with a note on quality-of-life (QOL). Indian J Otolaryngol Head Neck Surg. 2020.
Basak B, Gayen GC, Das M, Dhar G, Ray R, Das AK. Demographic profile of CSOM in a rural tertiary care hospital. IOSR J Pharm. 2014;4(6):43-6.
Wasson JD, Papadimitriou CE, Pau H. Myringoplasty: impact of perforation size on closure and audiological improvement. J Laryngol Otol. 2009;123(9):973-7.
Vignadutt P, Shaik A. A retrospective study on middle ear risk indices in analysing the postoperative outcome following tympanoplasty. Int J Otorhinolaryngol Head Neck Surg. 2019;5(5):1234-39.
Blom EF, Gunning MN, Kleinrensink NJ, Lokin AS, Bruijnzeel H, Smit AL, et al. Influence of Ossicular Chain Damage on Hearing After Chronic Otitis Media and Cholesteatoma Surgery: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2015;141(11):974-82.
Dornhoffer JL, Gardner E. Prognostic factors in ossiculoplasty: a statistical staging system. Otol Neurotol. 2001;22(3):299-304.
Kotzias SA, Seerig MM, Mello MFPC, Chueiri L, Jacques J, Silva MBCD, et al. Ossicular chain reconstruction in chronic otitis media: hearing results and analysis of prognostic factors. Braz J Otorhinolaryngol. 2020;86(1):49-55.
Vos C, Gersdorff M, Gerard JM. Prognostic factors in ossiculoplasty. Otol Neurotol. 2007;28(1):61-7.
Sousa A, Henriques V, Rodrigues J, Fonseca R. Ossiculoplasty in chronic otitis media: Surgical results and prognostic factors of surgical success. Acta Otorrinolaringol Esp. 2017;68(3):131-7.
