Optimizing Hearing Rehabilitation in Chronic Otitis Media: An Expert Opinion on Early Integration of Bone Conduction Devices.

Chronic otitis media (COM) frequently results in persistent hearing loss that is underrecognized and insufficiently addressed, even after successful surgical management. This expert opinion presents statements and treatment recommendations that advocate for the earlier integration of bone conduction device (BCD) solutions into the management of COM-related hearing loss. Expert opinions were developed through a structured, multiphase process integrating interdisciplinary expertise, a literature review, and patient perspectives. A core team drafted preliminary statements based on evidence from COM, hearing loss research, and clinical experience. These statements were discussed during a face-to-face roundtable in Vienna in September 2025 with 12 international experts, using a structured Think-Pair-Share format. Feedback from breakout groups, plenary discussions, and subsequent email reviews informed the final expert statements and treatment recommendations. Three statements were developed, refined, and agreed upon by the participants. Experts emphasized the early and proactive use of nonsurgical and surgical BCDs to support developmental, communicative, and functional outcomes. Optimal hearing interventions should be prioritized in parallel infection management and surgical interventions. Structured monitoring of hearing and quality of life is recommended to guide timely adjustments in the management of COM and related hearing loss. This expert opinion supports a shift toward the earlier integration of BCD solutions into the management of COM, emphasizing a dual focus on infection control and hearing rehabilitation.