Study of Predictive Value of Middle Ear Risk Index on Hearing Improvement in Patients Undergoing Surgery for Chronic Suppurative Otitis Media

Main Article Content

Bipin Kishore Prasad
Nitya
Ramesh

Abstract

Introduction: Middle ear risk index is one of the most reliable measuring tools to predict and evaluate the results of tympanoplasty. This study was done to analyse the predictive value of revised middle ear risk index on hearing improvement in patients undergoing surgery for chronic otitis media and to correlate the association between each index factor with hearing results.


Materials and Methods: This prospective observational study was done over 2 years in a tertiary care Army Hospital with 88 patients in the age group of 10-65 years. Preoperative hearing thresholds and air-bone gaps were recorded. Patients were assigned to mild, moderate and severe groups with risk index scores. Hearing thresholds were assessed at 3 and 6 months following surgery for chronic otitis media. Data was statistically analysed.


Results: 92.04% and 77.27% showed hearing improvements, 4.54% and 1.13% had deterioration and 3.40% and 21.59% had no change when compared to preoperative results in AC and BC thresholds respectively. 57.95% had post-operative closure of air bone gap of ≤ 12. Compared to cases with AB gap closure ≤ 12, those with AB gap closure > 12 showed statistically significant gain in BC by 0.2dB. Each unit increase in risk index score was associated with statistically significant increase of 0.64 dB in BC. Out of the seven individual factors, only perforation and previous surgery showed statistical significance in terms of hearing improvement.


Conclusion: Middle ear risk index is not a good predictor of hearing improvement in ear surgery. Individually, risk index or air bone gap are not strong predictors but jointly, they show strong association with hearing improvement both in terms of AC and BC.  


Keywords: Middle ear risk index; Air conduction; Bone conduction; Air-bone gap; Hearing improvement.

Article Details

How to Cite
Study of Predictive Value of Middle Ear Risk Index on Hearing Improvement in Patients Undergoing Surgery for Chronic Suppurative Otitis Media. (2024). Bengal Journal of Otolaryngology and Head Neck Surgery, 31(3), 136-147. https://doi.org/10.47210/bjohns.2023.v31i3.82
Section
Main article
Author Biographies

Bipin Kishore Prasad, Command Hospital (Central Command), Lucknow

Professor, Dept. of ENT

Nitya, Hind Institute of Medical Sciences, Sitapur (Uttar Pradesh)

Assistant Professor, Dept. of ENT

Ramesh, B L Kapoor Hospital, New Delhi

Director, Dept. of ENT

How to Cite

Study of Predictive Value of Middle Ear Risk Index on Hearing Improvement in Patients Undergoing Surgery for Chronic Suppurative Otitis Media. (2024). Bengal Journal of Otolaryngology and Head Neck Surgery, 31(3), 136-147. https://doi.org/10.47210/bjohns.2023.v31i3.82

References

Jacob A, Rupa V, Job A, Joseph A. Hearing impairment and otitis media in a rural primary school in South India. International journal of pediatric otorhinolaryngology. 1997; 39(2):133-138

Becvarovski Z, Kartush JM. Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI). Laryngoscop. 2001;111(10):1806-1811

Khalid A, Munahi A, Mohamed A. Middle ear risk index as a prognostic factor in pediatric ossicular reconstruction. Indian Journal of Otology. 2013; 19(1): 23-26

Chrobok V, Pellant A, Meloun M, Pokorny K, Simakova E, Mandysova P. Prognostic factors for hearing preservation in surgery of chronic otitis media. Journal of International Advanced Otology. 2009; 5(3): 310-317

Pinar E, Sadullahoglu K, Calli C, Oncel S. Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngol Head Neck Surg. 2008; 139(3): 386-390

Naderpour M, Moghadam YJ, Ghanbarpour E, Shahidi N. Evaluation of Factors Affecting the Surgical Outcome in Tympanoplasty. Iranian journal of otorhinolaryngology. 2016 Mar; 28(85):99-104

Lin YC, Wang WH, Weng HH, Lin YC. Predictors of surgical and hearing long-term results for inlay cartilage tympanoplasty. Archives of Otolaryngology–Head & Neck Surgery. 2011 Mar 21;137(3): 215-219

Ahmed A, Sharma SC. Middle Ear Risk Index [MERI] as Prognostic Factor in Tympanomastoidectomy with Tympanoplasty. Madridge J Otorhinol. 2016;1(1):15-22

Iurato S, Marioni G, Onofri M. Hearing results of ossiculoplasty in Austin-Kartush group A patients. Otology and Neurotology. 2001; 22: 140-144

Mills RP. The influence of pathological and technical variables on hearing results in ossiculoplasty. Clinical Otolaryngology and Allied Sciences. 2000; 25: 287-292

Risvana PP, Mubeena K. A retrospective study on middle ear risk indices in analysing the post-operative outcome following tympanoplasty. Int J Otorhinolaryngol Head Neck Surg 2021 Sep;7(9):1468–1472

Harugop AS, Abhilasha S, Desai PS. Assessment of middle ear risk index in predicting the outcome of treatment of CSOM. Int J Otorhinolaryngol Head Neck Surg 2020; 6:2075-2080.