Prognostic Role of MERI in the Outcome of Surgery in COM: A Tertiary Care Centre Experience

To establish a link between the MERI score and post-operative anatomical and audiological gain in COM. This prospective observational study was conducted at a tertiary care centre in North India from April 2023 to March 2024. It involved 63 patients aged between 10 and 60 years diagnosed with chronic otitis media (COM) who were scheduled for surgery and provided informed consent. The Middle Ear Risk Index (MERI) score was calculated based on patient's pre-operative and intra-operative findings. At 3 months post-surgery, pure tone audiogram was conducted and graft uptake status was assessed using otoendoscopy. In our study, 41 (65.1%) had mild (1-3) MERI score, 17 (26.9%) had moderate (4-6) MERI score, and 5 (7.93%) had severe (7-12) MERI score. Post-operative audiograms showed statistically significant improvement in hearing threshold in patients with mild MERI scores than in patients with moderate and severe MERI score. Graft uptake rates were highest in mild cases (78%), compared to moderate (76%) and severe (60%) MERI scores, with a statistically significant difference observed (p < 0.05). We could conclude from our study that patients with lower MERI scores had better outcome in terms of graft acceptance and hearing improvement. Thus, MERI score can be a simple and effective tool to predict the outcome of surgery in patients of COM.