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A Prospective Study on Middle Ear Risk Index (MERI) and Outcome of Tympanoplasty with a Note on quality-of-Life (QOL)

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Abstract

Chronic Otitis Media (COM) is a major indication for tympanoplasty. It is important to predict the outcome of surgery and give proper counselling for the patient. This avoids untoward expectations. To measure the outcome of patients who underwent tympanoplasty for mucosal type of chronic otitis media (COM) using Middle ear risk index (MERI) score. Any possible correlation of MERI score with outcomes? Assess quality-of-life. Prospective analytical comparative cohort study. Sample size was 75. All patients underwent tympanoplasty for mucosal type of COM with hearing loss. The patients were categorised into mild, moderate and severe groups based on the MERI score. The hearing benefit was calculated from the pre- and post-op difference in PTA. The graft uptake status was graded. The relation between MERI score, graft status and hearing benefit were analysed and compared. QOL was assessed by COMOT-15 questionnaire. Patients with a high MERI score had lower rate of graft uptake, whereas, patients with mild MERI had greater hearing benefit and those with severe MERI had lesser hearing benefit postoperative. MERI score is a prognostic tool to predict the outcome of tympanoplasty. It has an inverse relation with graft uptake and hearing benefit. Based on MERI score, the chances for surgical success and hearing benefit could be explained to the patient to give them realistic expectations.

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Author information

Authors and Affiliations

  1. Department of ENT and Head – Neck Surgery, Saveetha Medical College and Hospital, No. 1, Saveetha Nagar, Thandalam, Chennai, Tamil Nadu, 602105, India

    Lakshmi Shree Nallapaneni, Shyam Sudhakar Sudarsan & Srinivasan Krishnamoorthy

  2. Chennai, India

    Shyam Sudhakar Sudarsan

Authors
  1. Lakshmi Shree Nallapaneni
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  2. Shyam Sudhakar Sudarsan
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  3. Srinivasan Krishnamoorthy
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The author declares that they have no conflict of interest.

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Written informed consent obtained from participants before enrolling for the study.

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Appendix: Middle ear risk index chart

Appendix: Middle ear risk index chart

Risk factor

Value-assigned risk

Otorrhea (Bellucci)

 I—Dry

0

 II—Occasionally wet

1

 III—Persistently wet

2

 IV—Wet, cleft palate

3

Perforation

 None

0

 Present

1

Cholesteatoma

 

 None

0

 Present

2

Ossicular status (Austin/Kartush)

 (0) M_I_S_

0

 (A) M_S_

1

 (B) M_S_

2

 (C) M_S_

3

 (D) M_S_

4

 (E) Ossicular head fixation

2

 (F) Stapes fixation

3

Middle ear: granular or effusion

 No

0

 Yes

2

Previous surgery

 

 None

0

 Staged

1

 Revision

2

Smoker

 No

0

 Yes

2

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Nallapaneni, L.S., Sudarsan, S. & 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 74 (Suppl 1), 26–32 (2022). https://doi.org/10.1007/s12070-020-01796-y

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  • DOI: https://doi.org/10.1007/s12070-020-01796-y

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