Hentschel et al reported a model for diagnosing a high-risk lesion at the cerebellopontine angle. This can help to determine how best to perform imaging studies. The authors are from Radboud University Medical Center and Maastricht UMC+ in The Netherlands.
Patient selection: asymmetrical audiovestibular dysfunction (asymmetric hearing loss, asymmetric tinnitus, dizziness)
Parameters:
(1) gender
(2) rate of onset for hearing loss
(3) tinnitus
(4) aural fullness
(5) instability
(6) headache
(7) facial numbness
(8) facial nerve dysfunction
(9) asymmetry in bone conduction (BC) at 1 kHz (dB)
(10) asymmetry in bone conduction (BC) at 4 kHz (dB)
|
Parameter
|
Finding
|
Points
|
|
gender
|
female
|
0
|
|
|
male
|
0.065
|
|
rate of onset hearing loss
|
sudden
|
-0.325
|
|
|
gradual
|
0.082
|
|
|
none
|
0
|
|
tinnitus
|
unilateral
|
-0.471
|
|
|
none or bilateral
|
0
|
|
aural fullness
|
unilateral
|
0.007
|
|
|
none or bilateral
|
0
|
|
instability
|
no
|
0
|
|
|
yes
|
0.007
|
|
headache
|
no
|
0
|
|
|
yes
|
-0.052
|
|
facial numbness
|
no
|
0
|
|
|
yes
|
1.242
|
|
facial nerve dysfunction
|
no
|
0
|
|
|
yes
|
0.030
|
|
asymmetry BC at 1 kHz
|
no
|
0
|
|
|
yes
|
0.016
|
|
asymmetry BC at 4 kHz
|
no
|
0
|
|
|
yes
|
0.01
|
where:
• Facial nerve involvement are key findings.
value of X =
= SUM(points for all of the parameters) - 3.731
probability of cerebellopontine angle lesion =
= 1 / (1 + EXP((-1) * X))
The maximum probability shown by the model is 9.3%.
Performance:
• The area under the ROC curve is 0.67.
