Evaluation of Prognostic Factors and Middle Ear Risk Index in Type 1 Tympanoplasty

Abstract

Background: Chronic suppurative otitis media (CSOM) is a long-standing infection of middle ear cleft, characterized by ear discharge and permanent perforation of tympanic membrane. Surgical treatment of CSOM is still controversial. Recently many studies have been undertaken to evaluate the prognostic impact of various factors on the outcomes of tympanoplasty. Nonetheless, only few studies have assessed the clinical preoperative assessment method that allows for tympanoplasty outcome to be predicted. Objective: To examine the role of the prognostic factors and middle ear risk index on the success of tympanoplasty. Patients and methods: The medical records of 100 patients who underwent type 1 tympanoplasty between 2018 and 2020 were prospectively reviewed. Prognostic factors such as age, sex, presence of systemic diseases, location and size of perforation, duration of dry period, presence of myringosclerosis, presence of septal and conchal pathology, operation type, and status of the opposite ear were evaluated. Middle ear risk index (MERI) was calculated and its correlation with the rate of success of surgery was evaluated. Results: It was noticed that experience of surgeon more than 5 years, absence of comorbidities and low middle ear risk score were significant predictors for success of tympanoplasty type 1 (P < 0.001, P < 0.001, P < 0.001 respectively). Conclusion: We found that younger age, female gender, no comorbidities, and higher surgeon experience were associated with better outcome. In addition, patients with mild MERI score showed higher rate of success for tympanoplasty. The surgeon experience and MERI were independent predictors of successful procedure.