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MERI在慢性中耳炎手术结局中的预后作用:三级医疗中心经验

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

作者信息

Kalsotra Gopika, Sharma Himanshu, Saraf Neha, Fayaz Inna, Mahajan Vikas

机构信息

Department of ENT, SMGS Hospital, GMC Jammu, Jammu, India.

Department of Anatomy, HBT Medical College and Dr RN Cooper Municipal General Hospital, Mumbai, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5526-5530. doi: 10.1007/s12070-024-05024-9. Epub 2024 Sep 1.

Abstract

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 ( < 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.

摘要

建立中耳风险指数(MERI)评分与慢性中耳炎(COM)术后解剖学及听力学改善之间的联系。这项前瞻性观察性研究于2023年4月至2024年3月在印度北部的一家三级医疗中心进行。研究纳入了63例年龄在10至60岁之间、被诊断为慢性中耳炎且计划接受手术并签署知情同意书的患者。根据患者术前和术中的检查结果计算中耳风险指数(MERI)评分。术后3个月,进行纯音听力图检查,并使用耳内镜评估移植物吸收情况。在我们的研究中,41例(65.1%)患者的MERI评分为轻度(1 - 3分),17例(26.9%)为中度(4 - 6分),5例(7.93%)为重度(7 - 12分)。术后听力图显示,轻度MERI评分患者的听力阈值改善在统计学上显著优于中度和重度MERI评分患者。轻度病例的移植物吸收率最高(78%),而中度(76%)和重度(60%)MERI评分患者的移植物吸收率相对较低,差异具有统计学意义(<0.05)。我们可以从研究中得出结论,MERI评分较低的患者在移植物接受和听力改善方面预后更好。因此,MERI评分可以作为预测COM患者手术预后的一种简单有效的工具。

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