{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:03:45Z","timestamp":1784538225850,"version":"3.55.0"},"reference-count":11,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Chronic otitis media (COM) in children carries a risk of irreversible sensorineural hearing loss (SNHL), which impairs language development and academic performance, although an objective clinical threshold does not exist to identify patients requiring urgent surgical intervention. Methods: We retrospectively analyzed 60 pediatric patients (aged 5\u201318 years) who underwent surgery for COM or cholesteatoma and performed linear regression, Pearson\u2019s correlation, and receiver operating characteristic (ROC) curve analyses to quantify the relationship between otorrhea frequency and shifts in bone conduction (BC) threshold at least six months postoperatively. Results: Otorrhea frequency was significantly correlated with BC deterioration (r = 0.327, p = 0.011, R2 = 0.107). ROC analysis identified five or more episodes as the optimal cutoff for predicting a clinically significant BC shift of \u226510 dB (area under the curve = 0.712; sensitivity 75.0%, specificity 80.0%). Bacteriological findings, including the presence of non-skin commensal pathogens, did not significantly influence hearing outcomes (p = 0.721). Conclusions: Five or more otorrhea episodes constitute a quantitative, equipment-free red flag for imminent cochlear injury in pediatric COM, and this threshold provides primary care physicians and pediatricians a simple, age-independent criteria for timely surgical referral to prevent lifelong auditory morbidity.<\/jats:p>","DOI":"10.3390\/jcm15145653","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:54:13Z","timestamp":1784534053000},"page":"5653","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative Association Between Otorrhea Frequency and Sensorineural Hearing Risk in Pediatric Chronic Otitis Media"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7515-9202","authenticated-orcid":false,"given":"Yurino","family":"Nagata","sequence":"first","affiliation":[{"name":"Center for Advanced Hearing Implants and Hearing Aids, Gunma University Hospital, Department of Otolaryngology\u2013Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showamachi, Maebashi 371-8511, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0947-6526","authenticated-orcid":false,"given":"Masaomi","family":"Motegi","sequence":"additional","affiliation":[{"name":"Center for Advanced Hearing Implants and Hearing Aids, Gunma University Hospital, Department of Otolaryngology\u2013Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showamachi, Maebashi 371-8511, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7739-0102","authenticated-orcid":false,"given":"Kazuaki","family":"Chikamatsu","sequence":"additional","affiliation":[{"name":"Center for Advanced Hearing Implants and Hearing Aids, Gunma University Hospital, Department of Otolaryngology\u2013Head and Neck Surgery, Gunma University Graduate School of Medicine, 3-39-15 Showamachi, Maebashi 371-8511, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/00005537-200404000-00006","article-title":"Cochlear changes in chronic otitis media","volume":"114","author":"Cureoglu","year":"2004","journal-title":"Laryngoscope"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/00003446-199810000-00001","article-title":"Children with minimal sensorineural hearing loss: Prevalence, educational performance, and functional status","volume":"19","author":"Bess","year":"1998","journal-title":"Ear Hear."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1097\/AUD.0000000000000802","article-title":"Minimal and mild hearing loss in children: Association with auditory perception, cognition, and communication problems","volume":"41","author":"Moore","year":"2020","journal-title":"Ear Hear."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00003446-199602000-00001","article-title":"High frequency hearing loss associated with otitis media","volume":"17","author":"Hunter","year":"1996","journal-title":"Ear Hear."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0030-6665(20)31463-8","article-title":"Stability of tympanoplasty in children","volume":"22","author":"Tos","year":"1989","journal-title":"Otolaryngol. 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