Evaluation of middle ear risk index in patients undergoing tympanoplasty

Eur Arch Otorhinolaryngol. 2019 Oct;276(10):2769-2774. doi: 10.1007/s00405-019-05539-w. Epub 2019 Jul 17.

Abstract

Introduction: Tympanoplasty is a standard surgical procedure for the treatment of chronic otitis media. In this study, we aimed to determine the effect of the predictive factors of middle ear risk index (MERI) in patients undergoing tympanoplasty.

Materials and methods: A total of 200 patients who underwent tympanoplasty surgery from 2008 to 2018 at Khalili hospital in Shiraz were evaluated. In this study, variables such as age, sex, systemic diseases (diabetes mellitus, hypertension), location and size of tympanic membrane perforation (TMP), health of the opposite ear, dryness duration of the ear, presence or absence of myringosclerosis during surgery, type of operation and the risk of MERI were evaluated.

Results: The success rate for a 6-month follow-up of patients was 88%. Results showed that there was a significant difference between the MERI scores and the three types of operation of intact canal wall (ICW), canal wall down (CWD) and non mastoidectomy (P < 0.001). The longer the dryness duration of the ear, the MERI score was lower. When MERI score is low, the patient doesn't need mastoidectomy. Also, the worse the opposite ear, the higher the MERI score was. The highest MERI score was in patients undergoing CWD, and the lowest MERI score was in patients undergoing simple tympanoplasty.

Conclusion: MERI score is a useful tool for predicting the success rate of tympanoplasty and helps the surgeon planning the type of tympanoplasty.

Keywords: Chronic otitis media; MERI; Tympanoplasty.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myringoplasty
  • Otitis Media / surgery
  • Risk Assessment*
  • Tympanic Membrane Perforation / surgery
  • Tympanoplasty*
  • Young Adult