The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a patient with hearing and other aural complications following radiation and chemotherapy.
Subjective measures:
(1) pain
(2) tinnitus
(3) hearing
Objective measures:
(1) skin
(2) hearing
Management measures:
(1) pain
(2) skin
(3) hearing loss
Analytic studies:
(1) pure tone audiometry: assess the characteristics of sensorineural perception
(2) speech audiometry: assessment of characteristics of speech perception
If no toxicity is present, then the 0 points are assigned.
If a toxicity is present, then the grade indicates the number of points to assign.
|
|
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
pain |
occasional and minimal |
intermittent and tolerable |
persistent and intense |
refractory and excruciating |
|
tinnitus |
occasional |
intermittent |
persistent |
refractory |
|
hearing |
minor loss, no impairment |
frequent difficulties with faint speech |
frequent difficulties with loud speech |
complete deafness |
|
skin |
dry desquamation |
otitis externa |
superficial ulceration |
deep ulceration, necrosis, osteochondritis |
|
hearing loss in >= 1 frequencies |
< 10 decibel loss |
10 – 15 decibel loss |
16-20 decibel |
> 20 decibel loss |
|
management of pain |
occasional non-narcotics |
regular non-narcotic |
regular narcotic |
parenteral narcotics |
|
management of skin |
occasional lubrication or ointments |
regular eardrops or antibiotics |
eardrums |
surgery |
|
management of hearing loss |
NA |
NA |
hearing aid |
NA |
total score =
= SUM(points for all 8 items)
LENT score =
= (total score) / 8
Interpretation:
• maximum total score: 31
• minimum LENT score: 0
• maximum LENT score: 3.88
Specialty: Hematology Oncology, Otolaryngology
ICD-10: ,
