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A Prediction Nomogram for the Risk of Adhesive Otitis Media Based on Temporal Bone Computed Tomography: A
Jiawei Chen1,2, Xiaoxiao Liu1, Rui Li1,3
1Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
Background:
To develop a nomogram model for predicting the risk of adhesive otitis media based on temporal bone computed tomography (CT).
Methods:
A retrospective cross-sectional study was performed to analyze high-resolution CT images of the temporal bone in patients diagnosed with adhesive otitis media (AdOM). The comparison of the incidence of anatomical variants of the temporal bone between groups was performed. A nomogram for predicting the risk of AdOM was developed and validated.
Results:
A total of 153 ears from 110 patients were analyzed. In the AdOM group, 86% of the cases had poor mastoid pneumatization (MC0/MC1). The incidence rates of high jugular bulb (HJB), jugular bulb dehiscence, and agenesis of the mastoid antrum were 45.4%, 6.4%, and 2.7%. The incidence of HJB was significantly higher (P=.047), the sigmoid sinus-external auditory canal (SS-EAC) distance was significantly shorter (P < .001), and the depth of the dural plate was significantly deeper (P=.019) than in the control. The SS-EAC distance shortening was identified as an independent risk factor for the incidence of AdOM (odds ratio=1.34, P < .001). A nomogram for predicting the risk of AdOM was developed, with an area under the receiver operating characteristic curve of 0.751. The optimal cutoff value was -0.753 with sensitivity of 64.3% and specificity of 80.0%.
Conclusion:
The presence of HJB, a shorter SS-EAC distance, and a deeper dural plate depth may be associated with a higher incidence of AdOM. A novel nomogram based on anatomical variations of the temporal bone for predicting the risk of AdOM was developed to assist clinical decision-making in the treatment of otitis media.