Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI)

Area of Science:

• Otolaryngology
• Surgical Outcomes
• Public Health

Background:

• Middle ear disease severity can impact surgical success.
• Smoking is a known risk factor for various health complications.
• Understanding smoking's impact on middle ear surgery is crucial for patient care.

Purpose of the Study:

• To evaluate the effects of smoking on middle ear disease severity.
• To assess smoking's influence on surgical outcomes and graft success in tympanoplasty.
• To determine if smoking affects long-term hearing results.

Main Methods:

• Retrospective chart review of 74 patients undergoing over-under tympanoplasty.
• Analysis of preoperative disease severity using the Middle Ear Risk Index (MERI).
• Assessment of graft take, delayed graft failure, and audiologic data.

Main Results:

• Smokers showed a trend toward higher preoperative otorrhea and required more extensive surgery.
• Delayed graft failure occurred in 60% of smokers versus 20% of non-smokers (P = .050).
• No statistically significant difference in long-term hearing outcomes was observed between groups.

Conclusions:

• Cigarette smoking is linked to more severe preoperative middle ear disease.
• Smoking significantly increases the risk of long-term graft failure after tympanoplasty.
• The Middle Ear Risk Index (MERI) was revised to incorporate smoking as a risk factor.