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.