TYMPANOPLASTY AND ITS OUTCOME IN VARIOUS AGE GROUPS USING THE MIDDLE EAR RISK INDEX SCALE AT A TERTIARY CARE CENTRE IN EASTERN NEPAL

Abstract

Background: Tympanoplasty is done in cases of chronic otitis media. Middle Ear Risk Index (MERI) Scale is used to predict the outcome of tympanoplasty, based on various risk factors like otorrhoea, perforation, ossicular chain status, cholesteatoma, smoking and middle ear granuation/effusion. The objective of the study was to report the success rate of graft uptake, postoperative gain in hearing threshold and to find out the association of success to the different categories of MERI scale.

Methods: A prospective study of 75 cases of chronic otitis media who underwent tympanoplasty, was done over one year. Convenience sampling method was done. Clinical and audiological evaluation was done pre- and post- operatively. Risk categorization based on MERI scale was done. Data were recorded and analyzed using SPSS 16.

Results: Out of 75 cases, 39 (52%) cases were male and 36 (48%) were female. The mean age was 24.55 years±11.545. Overall, 53 (70.66%) cases had successful graft uptake. MERI 1-3 group had 82.6 % (38/46), MERI 4-7 group had 64.7 % (11/17) and MERI 8-12 group had only 33.33% (4/12) graft uptake, (p-value 0.003). Above-10-year age group had higher graft uptake rate and hearing gain. Graft acceptance was seen equal in dry or wet ear, and in unilateral or bilateral perforation.

Conclusions: Tympanoplasty done in cases with lower MERI scale and more than 10 years age group was associated with higher graft acceptance. More than 10 years age group had better hearing gain. The status of middle ear, dry or wet and laterality of perforation had no association for graft acceptance.