Determination of the Role of Middle Ear Risk Index as a Prognostic Tool in Cases of Chronic Suppurative Otitis Media Treated by Tympanoplasty

Background: The success rate of Tympanoplasty for the management of Chronic Suppurative Otitis Media (CSOM) ranges from 35% to 92%. A number of factors, such as age of patient, size and site of perforation, status of ear, ossicular status and surgical technique influence the success rate. The objective of this study was to assess the prognostic value of MERI in predicting the outcome of tympanoplasty in CSOM.

Methods: A one-year prospective observational study was conducted on 50 patients. The subjects were all cases of CSOM in the age group of 18-55 years with conductive hearing loss who underwent tympanoplasty with or without cortical mastoidectomy. The role of MERI was analyzed as a prognostic indicator.

Results: Graft uptake was successful in 92 percent of cases (n = 46). 32 of the 46 cases had a mild MERI score, ten had a moderate MERI score, and four had a severe MERI score. It was observed that higher MERI score correlated with lower rate of graft uptake.

Conclusion: Our study comprised of 50 patients of safe CSOM who were categorized into mild, moderate and severe on the basis of pre-operative MERI score. All of the patients had tympanoplasty with or without cortical mastoidectomy, and the surgical outcome was determined to be substantial in terms of graft uptake. Higher the MERI score, lower was the graft uptake rate, whereas lower the MERI score, higher incidence of graft uptake was seen. Thus, preoperative MERI can be a useful tool to ascertain the prognosis of tympanoplasty.