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A Nomogram Diagnostic Model for Eustachian Tube Dysfunction in Patients with Tympanic Membrane Perforation
Xiaoxin Chen1, Michael C F Tong1, Wai Tsz Chang1
1Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China.
Summary
A new diagnostic model effectively identifies Eustachian tube dysfunction (ETD) in patients with tympanic membrane perforation. This nomogram, utilizing ETS-5 scores and nasopharyngeal inflammation, offers high accuracy for diagnosing ETD.
Area of Science:
- Otolaryngology
- Diagnostic Medicine
- Medical Informatics
Background:
- Eustachian tube dysfunction (ETD) is prevalent in chronic otitis media.
- A validated diagnostic tool for ETD in tympanic membrane perforation is currently lacking.
Purpose of the Study:
- To develop and validate a novel diagnostic model for ETD in patients with tympanic membrane perforation.
Main Methods:
- Prospective study of 40 patients with tympanic membrane perforation.
- Data collection included clinical characteristics, otoscopy, nasal endoscopy, tubomanometry, and the 5-item Eustachian Tube Score (ETS-5).
- Logistic regression analysis identified independent predictors; a nomogram was constructed and validated using AUC, C-index, calibration curves, and DCA.
Main Results:
- The 5-item Eustachian Tube Score (ETS-5) and nasopharyngeal Eustachian tube opening mucosa inflammation were significant ETD predictors.
- The developed nomogram demonstrated high diagnostic performance with 80.0% sensitivity and 90.0% specificity.
- The model achieved an AUC and C-index of 0.901, indicating strong discrimination and good calibration.
Conclusions:
- The established nomogram model is effective and reliable for identifying ETD in patients with tympanic membrane perforation.
- The model's performance suggests utility in clinical practice for diagnosing ETD in this patient group.
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