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Background <p>Chronic suppurative otitis media (CSOM) is a long-standing inflammation of the middle ear mucosa characterized by tympanic membrane perforation and persistent or intermittent otorrhea (discharge lasting a minimum of 2–6&#xa0;weeks). Our study aimed to assess the middle ear risk index as a prognostic tool in tympanoplasty with mastoidectomy cases.</p> Methods <p>This single-center prospective observational study was performed at a tertiary care center from May 2024 to May 2025 comprising 60 patients with non-complicated safe CSOM candidate for post-auricular canal wall-up (CWU) tympanomastoidectomy through a post-auricular approach. Patients were assigned according to Austin-Kartush classification. All patients underwent multislice CT scan and pure tone audiometry (PTA).</p> Results <p>Hearing improvement was achieved in 39 (65%) patients, and successful graft uptake occurred in 45 (75%). Higher MERI scores were associated with poorer postoperative hearing outcomes. Spearman correlation demonstrated a significant negative association between MERI score and hearing improvement (<i>r</i> = −&#xa0;0.385, <i>p</i> = 0.002). On multivariate logistic regression analysis, MERI score emerged as the only independent predictor of hearing improvement (OR = 0.600, 95% CI: 0.370–0.990, <i>p</i> = 0.048).</p> Conclusions <p>Elevated MERI scores were significantly associated with unfavorable anatomical and functional outcomes, whereas lower scores correlated with successful graft uptake and greater hearing improvement.</p>

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Evaluation of the Middle Ear Risk Index (MERI) as a prognostic tool in cases of tympanoplasty with mastoidectomy

  • 期刊论文

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  • 发表日期：

    2026年2月20日

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  • Abd Elhakim Fouad Ghallab,
  • Ahmed Soliman Elkady,
  • Ahmed El-Sayed Fathy Salman,
  • Eslam Farid Abu Shady

摘要

Background

Chronic suppurative otitis media (CSOM) is a long-standing inflammation of the middle ear mucosa characterized by tympanic membrane perforation and persistent or intermittent otorrhea (discharge lasting a minimum of 2–6 weeks). Our study aimed to assess the middle ear risk index as a prognostic tool in tympanoplasty with mastoidectomy cases.

Methods

This single-center prospective observational study was performed at a tertiary care center from May 2024 to May 2025 comprising 60 patients with non-complicated safe CSOM candidate for post-auricular canal wall-up (CWU) tympanomastoidectomy through a post-auricular approach. Patients were assigned according to Austin-Kartush classification. All patients underwent multislice CT scan and pure tone audiometry (PTA).

Results

Hearing improvement was achieved in 39 (65%) patients, and successful graft uptake occurred in 45 (75%). Higher MERI scores were associated with poorer postoperative hearing outcomes. Spearman correlation demonstrated a significant negative association between MERI score and hearing improvement (r = − 0.385, p = 0.002). On multivariate logistic regression analysis, MERI score emerged as the only independent predictor of hearing improvement (OR = 0.600, 95% CI: 0.370–0.990, p = 0.048).

Conclusions

Elevated MERI scores were significantly associated with unfavorable anatomical and functional outcomes, whereas lower scores correlated with successful graft uptake and greater hearing improvement.