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Significance of the middle ear risk index in predicting tympanoplasty success in the elderly

  • Otology
  • Published:
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Abstract

Purpose

To evaluate the relationship between middle ear risk index (MERI) score and success of tympanoplasty in elderly (≥ 60 years) compared with young patients (18–59 years) and to investigate the prognostic factors affecting the success of tympanoplasty.

Methods

Patients were subdivided into three subgroups according to the MERI score as follows: mild (0–3), moderate (4–6), and severe (≥ 7). Ages, perforation sides and location, preoperative and postoperative audiological results, and the graft success of 29 patients aged over 60 years were compared with those of 52 patients aged between 18 and 59 years.

Results

Preoperative and postoperative air conduction, preoperative and postoperative bone conduction, and preoperative and postoperative air–bone gap (ABG) were higher in the older group compared with the younger group (p < 0.05). The hearing gain in the younger group was 12.63 (6.43), and in the older group was 12.66 (7.85), while did not differ significantly between groups (p = 0.689). Results demonstrated that cases with low/moderate score of MERI had a higher graft success rate compared with patients with a high score of MERI (Φ = 0.391; p < 0.001) as well as, patients with low/moderate score of MERI had the lower need for mastoidectomy compared with patients with a high score of MERI (Φ = 0.385; p = 0.001).

Conclusion

Low/medium MERI scores were the variables that provided realistic expectations and increased the success of tympanoplasty more precisely before surgery. The surgeon will also be able to design an operation strategy as a case study for elderly patients by doing so.

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References

  1. Emmett JR (1999) Age as a factor in the success of tympanoplasty: a comparison of outcomes in the young and old. Ear Nose Throat J 78:480–483

    Article  CAS  Google Scholar 

  2. Migirov L, Lipschitz N, Slonimsky G et al (2014) Efficacy of myringoplasty in older people. Aging Clin Exp Res 26:661–664. https://doi.org/10.1007/s40520-014-0221-3

    Article  PubMed  Google Scholar 

  3. Aoyagi M, Yokota M, Nakamura T, Tojima H, Kanayama R, Fuse T et al (1994) Effects of aging on hearing results in tympanoplasty. Acta Otolaryngol Suppl 511:81–86. https://doi.org/10.3109/00016489409128306

    Article  CAS  PubMed  Google Scholar 

  4. Adkins WY, White B (1984) Type I tympanoplasty: influencing factors. Laryngoscope 94:916–918. https://doi.org/10.1288/00005537-198407000-00011

    Article  CAS  PubMed  Google Scholar 

  5. Becvarovski Z, Kartush JM (2001) Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI). Laryngoscope 111:1806–1811. https://doi.org/10.1097/00005537-200110000-00026

    Article  CAS  PubMed  Google Scholar 

  6. Committee on Hearing and Equilibrium (1995) Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg 113:186–187. https://doi.org/10.1016/S0194-5998(95)70103-6

    Article  Google Scholar 

  7. Liu LL, Wiener-Kronish JP (2003) Perioperative anesthesia issues in the elderly. Crit Care Clin 19:641–656. https://doi.org/10.1016/s0749-0704(03)00058-7

    Article  PubMed  Google Scholar 

  8. Yoshida H, Miyamoto I, Takahashi H (2009) Is sensorineural hearing loss with chronic otitis media due to infection or aging in older patients? Auris Nasus Larynx 36:269–273. https://doi.org/10.1016/j.anl.2008.07.004

    Article  PubMed  Google Scholar 

  9. Proctor B (1960) A statistical review of 177 tympanoplasties performed in 1957–1958. AMA Arch Otolaryngol 71:469–477. https://doi.org/10.1001/archotol.1960.03770030111023

    Article  CAS  PubMed  Google Scholar 

  10. Shinnabe A, Hara M, Hasegawa M, Matsuzawa S, Kanazawa H, Yoshida N et al (2012) Clinical characteristics and surgical benefits and problems of chronic otitis media and middle ear cholesteatoma in elderly patients older than 70 years. Otol Neurotol 33:1213–1217. https://doi.org/10.1097/MAO.0b013e31825f24ba

    Article  PubMed  Google Scholar 

  11. Shishegar M, Faramarzi M, Ravari MR (2019) Evaluation of middle ear risk index in patients undergoing tympanoplasty. Eur Arch Otorhinolaryngol 276:2769–2774. https://doi.org/10.1007/s00405-019-05539-w

    Article  PubMed  Google Scholar 

  12. Ho KY, Tsai SM, Chai CY, Wang HM (2010) Clinical analysis of intratympanic tympanosclerosis: etiology, ossicular chain findings, and hearing results of surgery. Acta Otolaryngol 130:370–374. https://doi.org/10.1080/00016480903193429

    Article  PubMed  Google Scholar 

  13. Asiri S, Hahsam A, Al Anazy F, Zakzouk S, Banjar A (1999) Tympanosclerosis: review of literature and incidence among patients with middle-ear infection. J Laryngol Otol 113:1076–1080. https://doi.org/10.1017/s0022215100157937

    Article  CAS  PubMed  Google Scholar 

  14. Demirci S, Tuzuner A, Callıoglu EE, Akdaglı S, Karadaş H, Caylan R (2016) Tympanoplasty outcomes in elderly patients. Auris Nasus Larynx 43:33–36. https://doi.org/10.1016/j.anl.2015.05.002

    Article  PubMed  Google Scholar 

  15. Saito T, Tanaka T, Tokuriki M, Shibamori Y, Yamamoto T, Noda I et al (2001) Recent outcome of tympanoplasty in the elderly. Otol Neurotol 22:153–157. https://doi.org/10.1097/00129492-200103000-00006

    Article  CAS  PubMed  Google Scholar 

  16. Sakagami M, Maeda A, Node M, Sone M, Mishiro Y (2000) Long-term observation on hearing change in patients with chronic otitis media. Auris Nasus Larynx 27:117–120. https://doi.org/10.1016/s0385-8146(99)00065-6

    Article  CAS  PubMed  Google Scholar 

  17. Paparella MM, Brady DR, Hoel R (1970) Sensorineural hearing loss in chronic otitis media and mastoiditis. Trans Am Acad Ophthalmol Otolaryngol 74:108–115

    CAS  PubMed  Google Scholar 

  18. Ahn JH, An YS, Bae JS, Kim do Y, (2012) Postoperative results of tympanoplasty with mastoidectomy in elderly patients with chronic otitis media. Ann Otol Rhinol Laryngol 121:168–173. https://doi.org/10.1177/000348941212100305

    Article  PubMed  Google Scholar 

  19. Balyan FR, Aslan A, Taibah A, Russo A, Sanna M (1997) Mastoidectomy in noncholesteatomatous chronic suppurative otitis media: is it necessary? Otolaryngol Head Neck Surg 117(6):592–595. https://doi.org/10.1016/s0194-5998(97)70038-x

    Article  CAS  PubMed  Google Scholar 

  20. Webb BD, Joseph Chang CY (2008) Efficacy of tympanoplasty without mastoidectomy for chronic suppurative otitis media. Arch Otolaryngol Head Neck Surg 134(11):1155–1158. https://doi.org/10.1001/archotol.134.11.1155

    Article  PubMed  Google Scholar 

  21. Meranda D, Koike K, Shafiei M, Ramadan H (2007) Tympanometric volume: a predictor of success of tympanoplasty in children. Otolaryngol Head Neck Surg 136:189–192. https://doi.org/10.1016/j.otohns.2006.10.036

    Article  Google Scholar 

  22. Kumar N, Madkikar NN, Kishve S, Chilke D, Shinde KJ (2012) Using middle ear risk index and ET function as parameters for predicting the outcome of tympanoplasty. Indian J Otol 64:13–16. https://doi.org/10.1007/s12070-010-0115-4

    Article  Google Scholar 

  23. Pınar E, Sadullaoglu K, Calli C, Oncel S (2008) Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngol Head Neck Surg 139:386–390. https://doi.org/10.1016/j.otohns.2008.05.623

    Article  PubMed  Google Scholar 

  24. Denoyelle F, Roger G, Chauvin P, Garabedian EN (1999) Myringoplasty in children: predictive factors of outcome. Laryngoscope 109:47–51. https://doi.org/10.1097/00005537-199901000-00010

    Article  CAS  PubMed  Google Scholar 

  25. Belluci R (1973) Dual classification of tympanoplasty. Laryngoscope 83:1754–1758

    Google Scholar 

  26. Uyar Y, Keles B, Koc S, Ozturk K, Arbag H (2006) Tympanoplasty in pediatric patients. Int J Pediatr Otorhinolaryngol 70:1805–1809. https://doi.org/10.1016/j.ijporl.2006.06.007

    Article  PubMed  Google Scholar 

  27. Singh GB, Sidhu TS, Sharma A, Singh N (2005) Tympanoplasty type 1 in children: an evaluative study. Int J Pediatr Otorhinolaryngol 69:1071–1076. https://doi.org/10.1016/j.ijporl.2005.02.016

    Article  PubMed  Google Scholar 

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The authors declare that they have no funding.

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Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey

    Ergun Sevil

  2. Department of Otorhinolaryngology Head and Neck Surgery, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey

    Ahmet Doblan

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  1. Ergun Sevil
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Correspondence to Ergun Sevil.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Harran University Faculty of Medicine, reference numbers: 09.09.2019, 19/10/02) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Sevil, E., Doblan, A. Significance of the middle ear risk index in predicting tympanoplasty success in the elderly. Eur Arch Otorhinolaryngol 278, 3689–3695 (2021). https://doi.org/10.1007/s00405-020-06430-9

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  • DOI: https://doi.org/10.1007/s00405-020-06430-9

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