Abstract Background Chronic suppurative otitis media (CSOM) is a long-standing inflammation of the middle ear mucosa characterized by tympanic membrane perforation and persistent or intermittent otorrhea (discharge lasting a minimum of 2–6 weeks). Our study aimed to assess the middle ear risk index as a prognostic tool in tympanoplasty with mastoidectomy cases. Methods This single-center prospective observational study was performed at a tertiary care center from May 2024 to May 2025 comprising 60 patients with non-complicated safe CSOM candidate for post-auricular canal wall-up (CWU) tympanomastoidectomy through a post-auricular approach. Patients were assigned according to Austin-Kartush classification. All patients underwent multislice CT scan and pure tone audiometry (PTA). Results Hearing improvement was achieved in 39 (65%) patients, and successful graft uptake occurred in 45 (75%). Higher MERI scores were associated with poorer postoperative hearing outcomes. Spearman correlation demonstrated a significant negative association between MERI score and hearing improvement ( r = − 0.385, p = 0.002). On multivariate logistic regression analysis, MERI score emerged as the only independent predictor of hearing improvement (OR = 0.600, 95% CI: 0.370–0.990, p = 0.048). Conclusions Elevated MERI scores were significantly associated with unfavorable anatomical and functional outcomes, whereas lower scores correlated with successful graft uptake and greater hearing improvement.
Ghallab et al. (Fri,) studied this question.