Dong Z, Zhou M, Ye G, et al. - In this investigation involving 404 patients who underwent middle ear microsurgery for otitis media, researchers sought to develop and validate a clinical score to anticipate the risk of tympanosclerosis before surgery. Such patients were divided randomly into 2 cohorts: the training cohort (n = 243, 60%) and the validation cohort (n = 161, 40%). The multivariate analysis in the training cohort (n = 243, 60%) identified independent factors for tympanosclerosis as the female sex, the frequency-specific air-bone gap at 250 Hz ≥ 45 dB HL, aditus ad antrum blockage, type I eardrum calcification or type II eardrum calcification, and a history of otitis media ≥ 10 years, all included in the clinical score tool. Before surgery, the clinical score reached an optimum prediction of tympanosclerosis. A strong predictor of tympanosclerosis with stapes fixation is the presence of calcification pearls on the promontorium tympani.