Predictive Accuracy of Middle Ear Risk Index in Terms of Hearing Outcomes in Middle Ear Surgery

Abstract Introduction: Chronic otitis media (COM), affecting millions globally, remains a significant health concern despite antibiotic advancements. Evolving otological approaches focus on both dry ear attainment and hearing restoration. Grading systems such as middle ear risk index (MERI) can aid in stratifying disease severity and predicting surgical outcomes for effective patient management. Aims and Objectives: The study aimed to assess MERI scores in tympanomastoid surgery patients to categorize disease severity and evaluate its correlation with postoperative hearing improvement. Materials and Methods: A prospective study was conducted over 2 years on 50 patients of COM. Patients were categorized into three groups based on MERI scores developed by Becvarovski and Kartush. A preoperative audiometry was obtained. The type of middle ear surgery required for each patient was decided intraoperatively as per the findings. Patients were followed up for a 6-month period, and hearing improvement was assessed in terms of closure of air-bone gap in the postoperative audiogram. Statistical analysis was performed using SPSS v23 software for Windows, and P < 0.05 was considered statistically significant. Results: In our study, significant associations ( P < 0.05) were observed between the “MERI category” and variables such as otorrhea, cholesteatoma, ossicular status, previous surgery, middle ear granulation/effusion, smoker, total MERI score, and surgery performed. MERI was found to be negatively associated with hearing improvement, the higher the score lesser the improvement in hearing, and vice versa. Conclusion: The incorporation of MERI scoring into the surgical evaluation of COM cases holds promise for improving patient care and treatment strategies.