Background and Objectives: The diagnosis of cholesteatoma is usually clinic, and the only efficient treatment is surgical. High-resolution computed tomography (HRCT) is not considered absolutely necessary for the management of an uncomplicated cholesteatoma, but unsuspected situations from a clinical point of view can be discovered using the scans, warning the surgeon. Our objective is to compare HRCT scan information with intraoperative findings in patients with cholesteatoma and analyze the usefulness of a preoperative HRCT scan from a surgical point of view. Materials and Methods: This is a prospective descriptive study conducted in the Department of Otolaryngology, Victor Babes University of Medicine and Pharmacy Timisoara, Romania, from May 2021 to April 2022. It was carried out on 46 patients with a clinical diagnosis of cholesteatoma who were consequently operated on in our department. All patients received full clinical and audiological examinations. In all cases, an HRCT scan was performed preoperatively as a mandatory investigation. Preoperative HRCT scans were analyzed, and their findings were compared to the intraoperative notes. The two sets of observations were analyzed using standard statistical methods. Results: Extensive cholesteatoma was the most common type of disease, involving 46% of the patients, followed by pars flaccida cholesteatoma (35%) and pars tensa cholesteatoma (19%). Eroded scutum was the most frequent lesion involving 70% of the patients, followed by incus erosion (67%). Comparison of the HRCT and intraoperative findings revealed a very good correlation for tegmen tympani erosion, sigmoid plate erosion, scutum and malleus erosion, and a moderate-to-good correlation for lateral semicircular canal erosion, incus and stapes erosion, and fallopian canal erosion. Conclusions: HRCT is a valuable tool in the preoperative assessment of cholesteatoma, helping in making surgical decisions. It can accurately predict the extent of disease and is helpful for detecting unapparent dangerous situations. However, it is not very accurate in detecting fallopian canal and stapes erosion.

Conclusions: HRCT is a valuable tool in preoperative assessment of cholesteatoma, helping in making surgical decisions. It can accurately predict the extent of disease and is helpful for detecting unapparent dangerous situations. However it is not very accurate in detecting Fallopian canal and stapes erosion.

Speech audiometry is a key component of audiological as­ses­s­ment because it uses the types of auditory signals pre­sent in everyday communication. Speech audiometry can tell us more realistically than pure tone audiometry how a hearing disorder affects communication in everyday life. Speech audiometry test can thus be used for hearing status diag­nos­tic and to examine central auditory processing abi­lity and how this is affected by lesions in the middle ear, coch­lea, auditory nerve, brainstem pathways, or cortical au­di­tory centers. Furthermore, there is a predictable rela­tion­ship between a person’s hearing for pure tones and hearing for speech. Thus, the speech audiogram can serve as a cross-check on the validity of the pure tone audiogram.

Introduction. Otosclerosis is a progressive, incurable con­di­tion characterized by abnormal bone remodeling in the middle ear and otic capsule, leading to conductive or mixed hearing loss. A significant proportion of individuals with otosclerosis also experience tinnitus, which further im­pacts the quality of life. While surgical interventions, such as stapedectomy, remain the primary treatment, not all pa­tients are suitable candidates. Consequently, nonsurgical ma­nage­ment strategies, including hearing aids, cognitive be­ha­vio­ral therapy (CBT), pharmacological treatments and sound therapy, have gained increasing attention. Materials and method. We conducted a comprehensive literature re­view, analyzing peer-reviewed studies published between 1973 and 2025. Databases such as PubMed, Scopus, Web of Science and Google Scholar were searched using keywords re­la­ted to otosclerosis, tinnitus, nonsurgical management, phar­ma­co­lo­gi­cal interventions and rehabilitation stra­te­gies. Stu­dies were selected based on relevance to non­sur­gi­cal treat­ment modalities and their impact on auditory out­comes and tinnitus management. Data extraction and processing fo­cused on treatment efficacy, patient adhe­rence and the evo­lu­tion of otosclerosis. Results and discussion. Findings high­light that nonsurgical in­ter­ven­tions offer varied ef­fi­cacy de­pen­ding on individual pa­tient factors. Hearing aids im­prove sound input and can si­mul­ta­ne­ously reduce tin­ni­tus per­cep­tion through ambient sound am­pli­fi­cation. CBT and sound therapy show promise in addressing the psy­cho­lo­gi­­cal distress associated with tinnitus, although pa­tient ad­he­rence remains a challenge. Pharmacological in­ter­ven­tions, including bisphosphonates and fluoride the­rapy, have been explored, but their effectiveness in mo­di­fy­ing disease pro­gres­sion remains inconclusive. Ad­di­tio­nally, neu­ro­mo­du­la­tion techniques such as transcranial mag­ne­tic stimulation (TMS) have emerged as potential future the­ra­pe­u­tic answers. How­ever, large-scale, multicenter stu­dies are needed to va­li­date these findings and establish stan­dar­dized treatment pro­to­cols. Conclusions. The non­sur­gical management of otosclerosis-associated tinnitus is a multifaceted and evol­ving field, currently requiring in­di­vi­dua­lized treatment stra­te­gies. While hearing aids, CBT and sound therapy provide symp­to­ma­tic relief, pharmacological and neuromodulatory treat­ments require further research to determine their long-term efficacy. Future studies should fo­cus on personalized treat­ment approaches, incorporating both audiological and psy­cho­lo­gi­cal dimensions to optimize pa­tients’ outcomes and im­prove their quality of life.