A retrospective study on middle ear risk indices in analysing the postoperative outcome following tympanoplasty

P. Vignadutt, Ali Shaik


Background: Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem worldwide especially in developing countries where large percentage of the population lack specialized medical care. A normally functioning eustachian tube is an equally essential physiologic requirement for a healthy middle ear and normal hearing. In this study we have used the middle ear risk index (MERI) developed by Kartush which generates a numeric indicator of the severity of the middle ear disease to stratify patient groups according to the severity of the disease and to evaluate the efficiency of MERI score in predicting the outcome of tympanoplasty.

Methods: Patients who came and got operated for tympanoplasty to the ENT Department in Konaseema Institute of Medical Sciences and RF, Amalapuram during the study period of February 2017 to February 2018.  

Results: In this study graft was accepted in 22 patients (88%) and rejected in 3 (12%) patients. In patients in the mild MERI risk group n=22, graft was accepted in 21 (95%) patients and rejected in 1 patient (5%). Patient had a residual perforation. In patients in the moderate MERI risk group n=2, graft was accepted in 1 (50%) patients and rejected in 1 patient (50%).In severe risk group none of the grafts were accepted (100%).

Conclusions: MERI index is in fact a very useful and honest predictor of the graft uptake and audiological gain in patients undergoing tympanoplasty surgeries for CSOM. Lower the MERI index better the outcome. Positive Belluci criteria were also found to be inversely associated with the graft uptake.


Middle ear risk index, Postoperative outcome, Tympanoplasty

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