A STUDY TO ASSESS THE GRAFT UPTAKE AND AUDIOLOGICAL GAIN IN SURGICAL TREATMENT OF MIDDLE EAR DISEASE IN RELATION TO MIDDLE EAR RISK INDEX SCORE

Abstract

Chronic otitis media (COM) continues to be a major cause of preventable hearing loss in developing countries. The Middle Ear Risk Index (MERI) has been proposed as an objective method for stratifying disease severity and predicting surgical outcomes. However, regional data correlating MERI with surgical success remain limited.

Aims:

To assess graft uptake and audiological gain in relation to MERI scores in patients of COM undergoing ear surgery.

Materials and Methods:

A prospective longitudinal study was conducted in the Department of Otorhinolaryngology, Regional Institute of Medical Sciences, Imphal, from April 2023 to October 2024. A total of 108 patients aged 12–65 years with COM and conductive hearing loss underwent tympanoplasty (with or without mastoidectomy). Patients were categorized as mild (MERI 1–3), moderate (MERI 4–6), and severe (MERI 7–12). Postoperative graft uptake and hearing gain were evaluated by otoscopy and pure tone audiometry at 1 and 3 months. Data were analysed using SPSS v23 with p value < 0.05 considered significant.

Results:

Graft uptake rates were 95.3% in mild, 82.8% in moderate, and 46.7% in severe MERI groups (p < 0.001). Mean postoperative air–bone gap (ABG) improved across all groups, with percentage closure of 54.7%, 41.9%, and 28.3% respectively with respect to preoperative hearing thresholds. A significant negative correlation was observed between MERI score and both percentage audiological gain (r = –0.407, p < 0.001) and ABG closure (r = –0.543, p < 0.001).

Conclusion:

MERI scoring effectively predicts anatomical and functional outcomes following ear surgery for COM. Higher MERI scores are associated with lower graft success and poorer hearing improvement. MERI should be incorporated into preoperative evaluation for better prognostication and surgical planning.