Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241293068. doi: 10.1177/19160216241293068.
Eustachian tube dysfunction (ETD) is a common disease associated with chronic otitis media. A standard diagnostic tool for ETD in patients with tympanic membrane perforation is still lacking. We developed and validated a new diagnostic model for ETD in patients with tympanic membrane perforation.
A prospective study was conducted in patients who had tympanic membrane perforation from February to August 2023. We collected clinical characteristics and examination results including otoscopy, nasal endoscopy, tubomanometry, and 5-item Eustachian Tube Score (ETS-5). Univariate and multivariate logistic regression analysis was performed to determine the independent diagnostic factors. Based on this, the nomogram model was constructed. The discrimination and calibration of the nomogram were evaluated using the area under the curve (AUC), the C-index, the calibration curve, and the decision curve analysis (DCA).
A total of 40 participants were enrolled in the study. ETS-5 score and Eustachian tube opening mucosa inflammation in the nasopharynx were significant predictors in identifying ETD. Based on the above independent predictors, a diagnostic nomogram was successfully established. The sensitivity and specificity of the diagnostic model were 80.0% and 90.0%, respectively. The AUC and the C-index of the diagnostic model were both 0.901, which suggested that the model had a good discrimination power. The calibration curve indicated a good calibration degree of the model. DCA showed that the proposed model was useful for clinical practice.
The nomogram model is effective and reliable in identifying ETD in patients with tympanic membrane perforation.
咽鼓管功能障碍（ETD）是一种与慢性中耳炎相关的常见疾病。对于鼓膜穿孔患者的 ETD，目前仍缺乏标准的诊断工具。我们开发并验证了一种新的鼓膜穿孔患者 ETD 诊断模型。
前瞻性研究于 2023 年 2 月至 8 月期间在鼓膜穿孔患者中进行。我们收集了包括耳镜检查、鼻内镜检查、鼓室压测量和 5 项咽鼓管评分（ETS-5）在内的临床特征和检查结果。进行单变量和多变量逻辑回归分析以确定独立的诊断因素。在此基础上构建了列线图模型。使用曲线下面积（AUC）、C 指数、校准曲线和决策曲线分析（DCA）评估列线图的判别和校准能力。
共有 40 名参与者入组本研究。ETS-5 评分和咽鼓管开口黏膜在鼻咽部的炎症是识别 ETD 的重要预测因素。基于上述独立预测因素，成功建立了诊断列线图。该诊断模型的灵敏度和特异度分别为 80.0%和 90.0%。诊断模型的 AUC 和 C 指数均为 0.901，表明该模型具有良好的判别能力。校准曲线表明模型的校准程度良好。DCA 表明所提出的模型在临床实践中是有用的。
该列线图模型在识别鼓膜穿孔患者的 ETD 方面是有效且可靠的。
