Xie et al reported a nomogram for predicting hearing recovery for a patient with chronic otitis media. The authors are from Shandong University, Shandong First Medical University, and affiliated hospitals in Jinan, China.
Patient selection: chronic otitis media with hearing loss
Parameters:
(1) age in years, from 0 to 90
(2) duration in months, from 0 to 240
(3) surgery
(4) ossicular prosthesis (OP)
(5) granulation or calcified plaques around the ossicular chain (GCPAOB)
(6) ossicular chain integrity (OCI)
(7) duration of drilling (DOD) in minutes, from 15 to 65
(8) Eustachian tube dysfunction (ETD)
(9) mixed hearing loss (MHL)
(10) semicircular canal fistula (SCF)
(11) second surgery
points for age =
= (0.752 * (age))
points for duration =
= 100 - (0.42 * (months))
points for duration of drilling =
= 33.28 - (0.512 * (minutes)
|
Parameter
|
Finding
|
Points
|
|
surgery
|
CWU (canal wall up)
|
35.4
|
|
|
CWD (canal wall down)
|
0
|
|
|
tympanoplasty
|
36.2
|
|
ossicular prosthesis
|
no
|
34
|
|
|
PORP (partial ossicular replacement prosthesis)
|
9.5
|
|
|
TORP (total ossicular replacement prosthesis))
|
0
|
|
GCPAOB
|
no
|
9
|
|
|
yes
|
0
|
|
ossicular chain integrity
|
no
|
0
|
|
|
yes
|
50
|
|
Eustachian tube dysfunction
|
no
|
11.4
|
|
|
yes
|
0
|
|
|
Eustachian tube dilation
|
23.2
|
|
mixed hearing loss
|
no
|
14.8
|
|
|
yes
|
0
|
|
semicircular canal fistula
|
no
|
20
|
|
|
yes
|
0
|
|
second surgery
|
no
|
31
|
|
|
yes
|
0
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 411.5
value of X =
= (0.0333 * (score)) - 8.297
probability of hearing recovery =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.80 for both derivation and validation cohorts.
