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 mini‑
mum 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-Kar‑
tush 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 demon‑
strated 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 improve‑
ment (OR=0.600, 95% CI: 0.370–0.990, p=0.048).
Conclusions Elevated MERI scores were significantly associated with unfavorable anatomical and functional out‑
comes, whereas lower scores correlated with successful graft uptake and greater hearing improvement. |
