Retrospective study on middle ear risk indices in analyzing postoperative outcome following tympanoplasty
Middle Ear Risk Index (MERI) of a patient suffering from Chronic otitis media (COM) is a numerical grading to stratify the severity of disease. The aim of study was to evaluate MERI in the post operative outcome following tympanoplasty in terms of hearing improvement and graft uptake.
Materials and Methods
A retrospective study on patients with COM undergoing tympanoplasty within the age group 15-50 from February 2017 - February 2018 was done. Data was collected from the medical records department through case sheets. Graft uptake status at the end of one month was obtained from minor register. Post operative Audiograms done at end of 3 months were obtained from the Audiology Database.
25 patients with unilateral perforation were operated and followed up in this time period. There were 11 male and 14 female patients. 88% patients had mild MERI score, 8% had moderate and 4% had severe MERI scores. About 84% had mild conductive hearing loss while rest had moderate hearing loss. Graft acceptance was 88%, it was 95% in mild MERI and 50% in moderate MERI groups respectively. In occasionally wet ears graft rejection was 11% and 40% in persistently wet ears. The mean preoperative Air-Bone gap in the Mild MERI and Moderate MERI group were 21.45 decibel (dB) and 22.3 dB. The mean post- operative Air-Bone gap in the Mild MERI risk group was 10.35 dB and 14.5 dB in the moderate MERI risk group which was significant(p<0.05).
Hence MERI index is a very useful predictor of graft uptake and audiological gain in patients undergoing tympanoplasty surgeries.
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