Risk Factors and Predictive Model for Otitis Media With Effusion After Radiotherapy in Nasopharyngeal Carcinoma: A Retrospective Study

ABSTRACT Objective To investigate the impact of different radiation fields on the risk of otitis media with effusion (OME) in nasopharyngeal carcinoma (NPC) patients and to develop a nomogram to identify high‐risk patients after radiotherapy. Methods Clinical data were collected from 170 NPC patients who underwent radiotherapy at Peking Union Medical College Hospital (January 2016–December 2021, development group) and 73 patients (January 2022–June 2024, validation group). Multivariate logistic regression analyses were used to identify risk factors for OME, and a nomogram was constructed based on these findings. Results Multivariate analysis revealed that gender, invaded eustachian tube, and radiation to the parotid and periauricular field and parapharyngeal space were independent risk factors for OME. The nomogram demonstrated good discrimination, with AUC values of 0.813 (development group) and 0.798 (validation group). Calibration was confirmed with Hosmer–Lemeshow test results ( p > 0.33), and decision curve analysis indicated significant clinical utility within a threshold probability range of 0.09–0.94. When the risk threshold exceeded 0.38, the predicted high‐risk population matched well with actual OME cases, highlighting high clinical predictive efficiency. Conclusion In conclusion, radiation fields are significant risk factors for OME in NPC patients. The developed nomogram enables early identification of high‐risk patients, supporting timely intervention.