Rakshitha R, Surya Prakash D R, Chandrakiran C
Department of ENT, M S Ramaiah Medical College, Mathikere, Bangalore, 560054 India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1937-1942. doi: 10.1007/s12070-023-03740-2. Epub 2023 Apr 20.
In India, Chronic suppurative otitis media (CSOM) is a general public health issue leading to hearing loss which can be corrected surgically by Tympanoplasty. By applying predictors for a successful surgery the effectiveness of the surgery can be improved. In this study we aim to determine the usefulness of prognostic factors in predicting outcome of surgery for better patient compliance. 1. To compare MERI scores and saccharin test time in predicting graft uptake and hearing outcomes in Tympanoplasty surgery. A prospective study included all cases of mucosal type of CSOM of either sex according to the inclusion and exclusion criteria. Saccharin clearance time was used to assess Eustachian tube function and Pure Tone Audiometry has been done Pre-operatively to assess Hearing. Risk categories were assigned using MERI scoring chart and severity of disease assessed by otomicroscopy during surgery. Patients were post-operatively followed up to 6 months. Outcomes were assessed using Graft uptake, Hearing improvement and for recurrence of infection, compared with different categories of MERI and Saccharin time. The overall graft uptake was 96.6%. 100% successful graft uptake was seen among normal eustachian tube function. Hearing improvement after surgery may be predicted by saccharin and MERI test. Abnormal Saccharin test shows guarded prognosis in predicting the success of middle ear surgeries. Based on the MERI score and saccharin clearance time, hearing benefit and Surgical success can be assessed and patients can be counselled prior surgery regarding the expected outcome.
在印度,慢性化脓性中耳炎(CSOM)是一个导致听力损失的公共卫生问题,可通过鼓室成形术进行手术矫正。通过应用成功手术的预测指标,可以提高手术的有效性。在本研究中,我们旨在确定预后因素在预测手术结果以提高患者依从性方面的有用性。1. 比较MERI评分和糖精试验时间在预测鼓室成形术移植成功率和听力结果方面的作用。一项前瞻性研究纳入了所有符合纳入和排除标准的男女黏膜型CSOM病例。使用糖精清除时间评估咽鼓管功能,并在术前进行纯音听力测定以评估听力。使用MERI评分表划分风险类别,并在手术期间通过耳显微镜检查评估疾病严重程度。对患者进行术后6个月的随访。使用移植成功率、听力改善情况以及感染复发情况评估结果,并与不同类别的MERI和糖精时间进行比较。总体移植成功率为96.6%。在咽鼓管功能正常的患者中,移植成功率达100%。糖精试验和MERI试验可能预测术后听力改善情况。异常的糖精试验在预测中耳手术成功率方面显示预后不佳。基于MERI评分和糖精清除时间,可以评估听力获益和手术成功率,并在手术前就预期结果向患者提供咨询。