Search Results (180)

Background and Objectives: Eustachian tube (ET) dysfunction links adenoidal disease to persistent middle ear dysfunction in children, yet the independent contribution of ET orifice obstruction grade to audiological outcomes and health-related quality of life remains unquantified after adjustment for anatomical and inflammatory confounders. Because conventional anatomical grading (e.g., the Cassano classification) does not directly characterize the degree of ET orifice compromise, it may underestimate the functional threat to middle ear ventilation; this study is the first to quantify the independent predictive value of endoscopic ET obstruction grade. This study aimed to evaluate ET obstruction grade as an independent determinant of hearing thresholds, middle ear pressure, and quality-of-life impairment in children with chronic adenoiditis and otitis media with effusion. Materials and Methods: A retrospective cohort of 236 children (aged 3–12 years) was analyzed. ET orifice obstruction was graded endoscopically as none, partial, or complete. Primary outcomes included pure tone average (PTA), middle ear pressure (MEP), and OSA-18 total score. Multivariate linear and logistic regression models were fitted, adjusting for age, sex, Cassano grade, neutrophil-to-lymphocyte ratio (NLR), allergic status, and acute otitis media frequency. The modifying role of mucosal appearance (edematous versus fibrotic/remodeling) on quality-of-life outcomes was also assessed. Results: ET obstruction was absent in 42 (17.8%), partial in 114 (48.3%), and complete in 80 (33.9%) children. PTA increased progressively across groups (22.2 ± 5.5 to 36.2 ± 6.7 dB; p < 0.001), as did OSA-18 scores (44.9 ± 7.9 to 80.4 ± 10.3; p < 0.001). In adjusted analysis, each obstruction increment independently predicted a 5.57 dB PTA increase (95% CI 4.37–6.77; p < 0.001), a 14.89-point OSA-18 increase (95% CI 12.87–16.92; p < 0.001), and 5.12-fold higher odds of PTA > 30 dB (95% CI 2.84–9.24; p < 0.001). Persistent middle ear dysfunction at six months occurred in 7.1%, 26.3%, and 61.3% across obstruction grades. Among children with complete obstruction, fibrotic mucosa was associated with higher OSA-18 scores than edematous mucosa (82.3 vs. 76.8; p = 0.02). Conclusions: ET obstruction grade independently determines audiological and quality-of-life outcomes in pediatric chronic adenoiditis. Mucosal remodeling further amplifies quality-of-life burden in complete obstruction. These findings support routine ET endoscopic grading in pediatric otorhinolaryngology risk stratification. Full article

Background and Clinical Significance: To report an unusual case of a bilateral low-frequency air–bone gap consistent with an apparent conductive audiometric pattern following spinal anesthesia and discuss a possible underlying mechanism; Case Presentation: A 56-year-old man underwent elective inguinal hernia repair under spinal anesthesia. On the second postoperative day, he developed a severe postural headache followed by bilateral hearing loss. Otoscopic examination was normal. Tuning fork tests and pure-tone audiometry demonstrated a bilateral low-frequency air–bone gap consistent with an apparent conductive audiometric pattern. Laboratory findings were unremarkable. The patient was managed conservatively with bed rest, hydration and systemic corticosteroids, resulting in gradual clinical improvement; Conclusions: Hearing loss after spinal anesthesia is typically sensorineural and attributed to cerebrospinal fluid pressure alterations. This case highlights a rare apparent conductive audiometric pattern in the absence of clinically evident middle-ear pathology. A possible mechanism may involve altered inner-ear pressure dynamics leading to transient mechanical restriction of stapes mobility. Awareness of this atypical presentation may facilitate prompt recognition and appropriate management. Full article

Background/Objectives: Recurrent acute otitis media (AOM) in children is known to cause cumulative cochlear and vestibular injury. Whether a single fulminant episode severe enough to require surgical intervention produces an analogous long-term audiovestibular signature, and whether infection severity contributes to outcome independently of cumulative episode count, is unclear. The present study addressed this gap. Methods: In this single-centre retrospective cohort study, 65 paediatric patients who had undergone surgical treatment for acute mastoiditis—the fulminant form of AOM—between July 2001 and March 2021 were assessed a median of 11.5 years after surgery. Of these, 35 had undergone mastoidectomy with tympanostomy and 30 had undergone tympanostomy alone because their episode had not been severe enough to require mastoidectomy. Thirty-two age-matched healthy volunteers (one ear each) formed the control group, yielding 97 ears in three groups (Group TM, 35 ears; Group T, 30 ears; Group C, 32 ears). Extended high-frequency pure-tone audiometry (125–20 kHz), distortion-product otoacoustic emissions (DPOAEs), single-frequency and wideband tympanometry, ipsilateral acoustic reflex thresholds, and lateral-canal vestibulo-ocular reflex gain were measured. Results: Both operated groups showed significantly elevated audiometric thresholds in the high- and extended high-frequency ranges compared with controls (HTA: χ² = 24.25, p < 0.001), with corresponding reductions in DPOAE amplitudes (HTA: χ² = 25.04, p < 0.001). Group TM did not differ significantly from Group T at any frequency band, indicating a negligible additional contribution of mastoidectomy itself. Acoustic reflex thresholds were elevated in Group TM. Vestibulo-ocular reflex gain was within reference ranges in all groups. Conclusions: A single fulminant episode of acute middle-ear infection in childhood—whether severe enough to require mastoidectomy or treated by tympanostomy alone—was associated, more than a decade later, with significantly elevated audiometric thresholds closely resembling those reported after multiple recurrent infections, supporting an effect of infection severity independent of cumulative episode count. Long-term audiological follow-up with extended high-frequency audiometry and otoacoustic emission testing is warranted, irrespective of whether mastoidectomy was required. Full article

Objectives: ANCA-associated vasculitis (AAV) is a relapsing–remitting systemic disease in which auditory involvement is increasingly recognized as a determinant of quality of life. The objective of this study was to evaluate hearing outcomes during induction therapy in AAV and to assess the applicability of sudden sensorineural hearing loss (SSNHL) criteria for monitoring treatment response. Methods: A prospective study included 27 patients with AAV hospitalized at the Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine–National Research Institute. Audiologic assessment included pure-tone audiometry (including high-frequency audiometry), immittance audiometry, otoacoustic emissions, and auditory brainstem response (ABR). Examinations were performed at baseline (induction phase) and after remission. Hearing outcomes were evaluated using SSNHL criteria defined by the Ministry of Health and Welfare of Japan. Associations between hearing loss and organ involvement were also analyzed. Results: Improvement to normal hearing in pure-tone audiometry was observed in three ears, while deterioration from normal hearing occurred in four ears. No statistically significant differences were found in overall otoacoustic emission responses between baseline and follow-up. A statistically significant association was identified between hearing loss and peripheral nervous system involvement (50.0% vs. 11.1%, p = 0.057). No significant correlations were observed between hearing outcomes and other clinical parameters. Conclusions: SSNHL-based hearing outcome criteria may represent a practical tool for assessing auditory dysfunction and monitoring treatment response in AAV. High-frequency audiometry and structured outcome measures may improve detection of subtle cochlear changes. Further studies with larger cohorts are required to validate these findings and clarify the relationship between systemic disease activity and hearing impairment. Full article

Objectives: This study evaluated auditory performance and quality of life in cochlear implant recipients aged 60 years and older, and identified factors associated with postoperative outcomes. Methods: This cross-sectional descriptive study included 34 patients aged 60 years and older who underwent unilateral cochlear implantation between 2002 and 2020 at the Department of Otolaryngology, Çukurova University Faculty of Medicine. Preoperative WHOQOL-BREF data were not available; postoperative outcomes were therefore assessed against demographic and clinical predictors rather than within-patient change. The patients were grouped by preoperative hearing loss duration (1–3, 4–6, or ≥7 years), daily device use (<11 vs. ≥11 h), and age (60–70 vs. >70 years). Auditory gain was assessed by pure-tone audiometry, quality of life by the WHOQOL-BREF, and cognitive status by the Montreal Cognitive Assessment (MoCA). Cohen’s d, η² and 95% CIs were reported, multiple comparisons were Benjamini–Hochberg-corrected, and multivariable linear regression was applied per domain. Results: The cohort comprised 19 women (55.9%) and 15 men (44.1%), with a mean age of 66.06 ± 5.8 years; eight patients (23.5%) were older than 70. Mean audiological gain was 45.5 ± 13.1 dB and varied with preoperative duration (η² = 0.50, p < 0.001; 1–3 vs. ≥7 years Δ 20.9 dB, 95% CI 12.2–29.6; d = 2.04). Daily device use was a consistent predictor of well-being: those using their implant for more than 11 h daily scored higher across all WHOQOL-BREF subscales (all q ≤ 0.011; d −1.45 to −2.50). Comorbidity was associated with lower scores in four of five domains (q ≤ 0.048; d −0.85 to −1.26), and a higher MoCA score independently predicted the psychological subscale (β = +1.0 per point; p = 0.014). Apparent sex and education effects did not survive correction. Mean preoperative hearing thresholds were 84.3 ± 7.9 dB and 76.1 ± 16.2 dB in patients under and over 70, respectively; postoperative thresholds were 37.8 ± 10.4 dB and 33.9 ± 6.8 dB, with no significant between-group difference in gain (d = 0.32). Conclusions: In this cross-sectional cohort, cochlear implantation was associated with substantial audiological gain and favourable quality-of-life scores in patients aged 60 and older, with an acceptable safety profile. Age alone did not constrain outcomes; the absence of preoperative QoL data precludes direct quantification of within-patient change. Full article

Background/Objectives: Sequential bilateral cochlear implantation is being increasingly considered in paediatric patients with bilateral profound hearing loss, particularly when the contralateral ear shows limited residual hearing or poor speech discrimination. Although auditory benefits of a second cochlear implant (CI2) have been reported, concerns remain regarding possible vestibular impairment after surgery. This study aimed to provide a preliminary prospective evaluation of early audiological and vestibular outcomes in children undergoing sequential bilateral cochlear implantation and to explore whether the age at implantation or the inter-implant interval influenced longitudinal trajectories. Methods: Ten children with prelingual bilateral profound sensorineural hearing loss who underwent sequential bilateral cochlear implantation were prospectively enrolled. Assessments were performed at baseline and during follow-up up to 12 months after CI2 activation. The audiological evaluation included pure-tone audiometry, speech recognition in quiet with CI2 alone and bilaterally, and speech-in-noise testing in frontal and lateralised configurations. The vestibular evaluation included static stabilometry and video head impulse testing. Patient-reported outcomes were assessed using the speech, spatial and qualities of hearing scale for children. Longitudinal changes were analysed using mixed-effects models with false discovery rate correction. Results: Unilateral speech recognition with CI2 improved significantly over time, with median word recognition increasing from 0% at 3 months to 60% at 12 months (p < 0.0001; q = 0.0001). The speech-in-noise performance also improved significantly in the frontal and F1C configurations. Bilateral speech recognition in quiet remained stable at high levels, consistent with a ceiling effect. The vestibular measures were broadly stable at the group level, and the SSQ scores showed modest, non-significant changes. Exploratory analyses did not identify consistent effects of the implantation age or inter-implant interval on longitudinal trajectories. Conclusions: Sequential bilateral cochlear implantation was associated with early auditory benefit, particularly for CI2 unilateral performance and speech perception in noise, without evidence of major short-term vestibular deterioration. Full article

Post-traumatic auditory and vestibular complaints are frequent after traumatic brain injury (TBI) and temporal bone trauma. They create particular difficulty in medico-legal practice because the evaluator must distinguish diagnosis, functional impact, plausibility of traumatic causation, and the credibility of reported deficits and/or symptoms. This manuscript is a narrative expert review, not a systematic review or a validated forensic prediction rule. It aims to synthesize clinically relevant evidence and propose a practical cross-check framework for structured audio-vestibular assessment in post-traumatic and medico-legal contexts. Pure-tone audiometry remains the functional entry point, but it should be interpreted in conjunction with speech audiometry, tympanometry, acoustic reflexes, transient-evoked and distortion-product otoacoustic emissions, auditory brainstem responses, and auditory steady-state responses. Vestibular evaluation should combine videonystagmography, video head impulse testing, cervical and ocular vestibular evoked myogenic potentials, and computerized dynamic posturography, recognizing that each method interrogates different physiological domains and frequencies. Particular emphasis is placed on the separation between clinical diagnosis, physiological localization, functional impairment, and medico-legal attribution. The article also discusses safeguards against false-positive attribution of malingering, the time course after TBI, inter-rater variability, and the role of specialist expertise in medico-legal reporting. The proposed framework does not eliminate uncertainty; rather, it is intended to make expert reasoning transparent, cautious, internally consistent, and defensible. Full article

Ototoxicity represents a clinically significant complication of anticancer therapy in pediatric patients. Cytotoxic agents used in oncology, particularly platinum-based chemotherapy, may induce damage to the auditory and vestibular systems, resulting in hearing loss, tinnitus, and balance disturbances. Even mild hearing impairment during childhood may negatively affect speech perception, language development, communication abilities, and subsequent educational and psychosocial functioning. This narrative review aims to synthesize current evidence on treatment-related ototoxicity in children, with particular focus on commonly implicated therapies, clinical consequences, diagnostic approaches, and potential preventive strategies. A focused literature search was conducted in PubMed for publications from 2019 to 2025 addressing ototoxicity associated with pediatric anticancer treatment and audiological monitoring methods. The analysis indicates that platinum-based compounds, especially cisplatin and carboplatin, remain the primary agents associated with ototoxicity, with reported incidence ranging from approximately 20–70% for cisplatin and 10–30% for carboplatin. Additional risk factors include young age, baseline hearing status, renal function, and exposure to other ototoxic agents such as aminoglycoside antibiotics. Early detection relies on comprehensive audiological monitoring combining behavioral and objective methods, including pure-tone audiometry, extended high-frequency audiometry, otoacoustic emissions, and auditory brainstem response testing. Standardized grading systems such as ASHA, Brock, Chang, and SIOP Boston criteria play a key role in identifying and classifying ototoxic changes. Emerging research focuses on improved monitoring protocols, biomarker identification, and the development of otoprotective strategies, including sodium thiosulfate and experimental molecular therapies. Implementing systematic hearing monitoring and preventive strategies is essential to reduce long-term auditory complications and improve quality of life in pediatric cancer survivors. Full article

Background: Congenital hearing loss occurs in about 2 of every 1000 newborns, of which half probably have a genetic origin. In syndromic patients, hearing impairment often results from craniofacial malformations affecting the outer and middle ear. Anatomical limitations such as microtia or external auditory canal atresia often preclude conventional air-conduction hearing aids, leaving bone-conduction devices as one viable option. However, surgical intervention in such patients is challenging. This study aimed to evaluate the audiological outcomes, safety, and effectiveness of the Bonebridge BCI 602 implant in 10 patients with genetic syndromes. Methods: The case series was made up of 10 patients aged 6–45 years, each diagnosed with a congenital syndrome affecting the external and/or middle ear. All cases involved surgical implantation of the Bonebridge system. Audiological outcomes were evaluated in free-field conditions on the day of sound processor activation and at 3–6 months follow-up via pure-tone and speech audiometry. Results: All surgical procedures were completed without serious adverse events, and the incidence of postoperative complications was low. Audiological outcomes showed clinically significant hearing improvement in all patients following Bonebridge implantation. Post-implantation hearing thresholds ranged from 25 to 40 dB HL, with notable gains in speech perception in both quiet and noisy environments. Conclusions: The Bonebridge implant appears to be a safe and effective option for auditory rehabilitation in patients with hearing loss associated with various genetic syndromes involving craniofacial malformation. However, this complex patient population requires individual assessment, interdisciplinary evaluation, and careful surgical planning. Full article

Background/Objectives: The objective of this scoping review was to map and critically describe emerging speech-in-noise assessment tools developed over the last decade for the evaluation of hearing loss beyond conventional audiological measures. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive literature search was performed in the PubMed/MEDLINE, Scopus, and Embase databases. A comprehensive review of studies describing novel or emerging SIN-based assessment tools was conducted, with a particular emphasis on those including adult participants with normal hearing and hearing loss. Results: Nine studies met the inclusion criteria and were included in the review. The identified tools cover a range of methodological innovations, including advanced digits-in-noise paradigms, antiphasic and binaural presentation modes, optimized adaptive procedures, and digital or automated testing platforms. Several studies also incorporated artificial intelligence-based approaches, such as machine learning, text-to-speech, and automatic speech recognition, to enhance test development, administration, and hearing loss classification. Across all studies, SIN measures demonstrated the ability to reliably differentiate between normal hearing listeners and individuals with hearing loss and to provide complementary information beyond pure-tone audiometry. Conclusions: Emerging speech-in-noise tools show considerable potential to improve the functional assessment of hearing loss and to support more sensitive, accessible, and scalable approaches for hearing evaluation. Further research is required to assess their clinical integration and long-term impact on hearing screening and diagnostic pathways. Full article

Background: Turner syndrome is a genotypic disorder in females characterized by the total or partial absence of an X chromosome. While cardiovascular issues and sensorineural hearing loss are well-documented, vestibular system involvement remains understudied. This study aims to examine vestibular system involvement in patients with Turner syndrome and assess if they exhibit a higher prevalence of peripheral vestibular pathology compared to the general population. Methods: A retrospective longitudinal study was conducted with 21 Turner syndrome patients and 21 age-matched controls. Evaluations included clinical history, otoscopy, pure tone audiometry, the Video Head Impulse Test (vHIT) to measure vestibulo-ocular reflex gain, and computerized dynamic posturography, specifically the Sensory Organization Test (SOT) and Stability Limits Analysis. Results: Turner syndrome patients showed significantly higher hearing thresholds across all frequencies compared to controls (p < 0.001). In the vHIT, 30% of the Turner group presented pathological results, with significant gain reductions in the right horizontal and left posterior semicircular canals. Posturography revealed a significant reduction in overall stability (p = 0.006) and a significantly lower vestibular index (p = 0.011) in the Turner group. Additionally, patients with Turner syndrome demonstrated significant impairments in directional control, reaction time, and excursion points during Stability Limits Analysis. Conclusions: Patients with Turner syndrome are more likely to experience vestibular disorders, a finding likely associated with estrogen deficiency and the loss of its protective effect on the inner ear. These results highlight the necessity of including vestibular and posturographic assessments in the routine clinical follow-up of these patients to facilitate early detection and rehabilitation, even in the absence of overt symptoms like vertigo. Full article

Objectives: Ear involvement is a common feature of antineutrophil antibody (ANCA)-associated vasculitis (AAV). The vigilance of otolaryngologists often determines early diagnosis of AAV, thereby reducing the risk of irreversible organ damage and improving the quality of life of these patients. The goal of this study was to assess the quantitative and qualitative hearing impairment in patients with active AAV and to identify an audiological test that can detect of early deterioration of hearing even in patients without hearing loss. Methods: A study group of 46 patients with ANCA-associated vasculitis (AAV) hospitalized at the Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine—National Research Institute and a control group of 20 patients without a diagnosis of ANCA vasculitis and with no reported hearing disturbances were assessed prospectively. A battery of audiologic tests were carried out including High Frequency Audiometry, Impedance Audiometry, Otoacoustic Emissions, and Auditory Brainstem Responces (ABR). Computed Tomography of temporal bones and paranasal sinuses were performed, and audiologic anamnesis was gathered. Results: Pure-tone audiometry (PTA) demonstrated hearing loss in 58.6% (51/87) of the ears in the study group. The predominant type of damage was sensorineural hearing loss (SNHL). No correlation was found between hearing loss and AAV activity, duration of the disease, number of relapses, or ANCA antibody type. The statistically significant differences between control group and study group, even after excluding patients with hearing loss, were observed for high frequency audiometry (p < 0.001, for all tested frequencies excluding 14,000 Hz). The otoacoustic emissions showed to be statistically insignificant after exclusion of patients with hearing loss. Conclusions: Hearing involvement is common in patients with AAV regardless of the type of ANCA antibodies. High Frequency Audiometry could be an important audiologic screening test in this group of patients, and should be incorporated to diagnostic test battery in AAV. Otoacoustic emissions and ABR can be a handful in uncertain cases. Full article

Background and Objectives: Essential tremor (ET) is the most prevalent movement disorder, yet its neurophysiological basis remains incompletely understood. Emerging evidence indicates that ET may involve non-motor manifestations, including auditory dysfunction. Given the anatomical convergence of tremor-related and auditory pathways at the brainstem level, electrophysiological assessment of the auditory system may provide insights into ET pathophysiology. This study aimed to evaluate auditory pathway function in patients with essential tremor using conventional audiometry, brainstem auditory evoked potentials (BAEP), and medium-latency auditory evoked potentials (MLAEP), and to examine their associations with tremor characteristics. Materials and Methods: Thirty patients with ET (mean age 56.6 ± 19.2 years; 15 women) and 30 healthy controls with similar age and sex distribution underwent pure-tone audiometry, BAEP, and MLAEP recordings. Tremor severity and distribution were assessed using a standardized evaluation based on the Fahn–Tolosa–Marin Tremor Rating Scale. Results: Conventional audiometry demonstrated normal hearing thresholds in 63.3% of ET patients and 83% of controls, while sensorineural hearing loss was observed in 36.6% and 16.6%, respectively (p > 0.05). High-frequency hearing loss (HFHL) was significantly more prevalent in the ET group (p = 0.003). BAEP analysis revealed significant prolongation of peak latencies in right-sided waves II and III and left-sided waves I and II in ET patients compared with controls (p < 0.05), whereas interpeak latencies (I–III, III–V, I–V) did not differ between groups. MLAEP latencies (Na, Pa, Nb) showed no significant differences between ET patients and controls (all p > 0.05) and were not associated with tremor severity, disease duration, or hearing asymmetry. Conclusions: High-frequency hearing loss is more prevalent in essential tremor, and selective BAEP latency changes observed in the context of preserved interpeak intervals suggest predominantly delayed peripheral auditory input rather than a primary brainstem conduction abnormality. Preserved MLAEP responses indicate relative sparing of thalamocortical auditory processing, supporting the concept of essential tremor as a multisystem network disorder in which altered auditory input may interact with broader network-level mechanisms. Full article

Background/Objectives: Macular telangiectasia type 2 (MacTel2) is a progressive parafoveal retinal disorder with emerging evidence supporting broader neurodegenerative and metabolic involvement. Given the vulnerability of cochlear structures to systemic and microvascular stressors, this study aimed to investigate whether MacTel2 is associated with measurable auditory dysfunction. Methods: This prospective case–control study included 42 participants: 21 patients with clinically and multimodally confirmed MacTel2 and 21 age- and sex-matched healthy controls. All participants underwent standardized audiological assessment, including tympanometry, conventional and extended high-frequency pure-tone audiometry (0.5–16 kHz), distortion product otoacoustic emissions (DPOAE; 0.5–8 kHz), and click-evoked auditory brainstem response (ABR). Hearing loss was graded using the World Health Organization (WHO) classification based on PTA4 (0.5, 1, 2, and 4 kHz), and a clinically relevant cutoff of PTA4 > 25 dB HL was additionally applied. DPOAE responses were considered absent when the signal-to-noise ratio (SNR) was <6 dB. Results: The MacTel2 and control groups were comparable with respect to age and sex distribution. Patients with MacTel2 demonstrated significantly higher air-conduction thresholds than controls across both conventional and extended high frequencies, with the largest differences observed in the extended high-frequency range (10–16 kHz). PTA4 values were significantly higher in the MacTel2 group in both better- and worse-hearing ears, and the prevalence of clinically relevant hearing loss (PTA4 > 25 dB HL) was significantly greater among MacTel2 patients. DPOAE amplitudes were markedly reduced at all tested frequencies (0.5–8 kHz) in the MacTel2 group, and frequency-specific DPOAE absence/reduction (SNR < 6 dB) was substantially more frequent in MacTel2 than in controls. In contrast, ABR wave I and wave V latencies and the I–V interpeak interval did not differ significantly between groups, suggesting preserved brainstem-level auditory conduction. Within the MacTel2 cohort, no significant correlations were observed between the disease grade and audiological measures. Conclusions: MacTel2 was associated with significantly impaired peripheral auditory function, characterized by elevated conventional and extended high-frequency thresholds and pronounced reductions or the absence of DPOAE responses, while ABR parameters remained comparable to those of controls. These findings support a predominantly cochlear (outer hair cell-related) involvement in MacTel2 and suggest that auditory screening including conventional pure-tone audiometry, with consideration of extended high-frequency audiometry and otoacoustic emissions when feasible, may be clinically relevant in this population. Full article

Primary Objective: To characterize high-resolution computed tomography (HRCT) fracture patterns, namely orientation and otic capsule status, among Sudanese patients with acute temporal bone trauma. Secondary Objectives: (i) To quantify the prevalence and pattern of concomitant craniofacial fractures, (ii) to describe early audiologic outcomes, and (iii) to document facial nerve dysfunction. Methods: Prospective cross-sectional study of 45 consecutive patients (≥5 years) with HRCT-confirmed TBF sustained within 7 days of injury, managed at two tertiary otolaryngology centers in Khartoum (October 2022–March 2023). All imaging, clinical, and audiologic variables were recorded once at the index presentation (≤7 days after trauma); the study did not include longitudinal follow-up. Two blinded experts independently classified fracture orientation (longitudinal, transverse, mixed/oblique), otic capsule status (sparing [OCS] vs. otic capsule-violating [OCV]), and ancillary HRCT signs (ossicular chain disruption, tympanic plate fracture, pneumolabyrinth/CSF leak); inter-observer reliability was assessed with Cohen’s κ. Concomitant craniofacial fractures, pure-tone audiometry, and House–Brackmann facial nerve grades were recorded. Predictor–outcome associations were examined with χ² statistics (p < 0.05). Results: Mean age 35.9 ± 17.4 years; 78% male. Road traffic accidents were associated with 58% of injuries. HRCT showed 60% longitudinal, 20% transverse, and 20% mixed/oblique fractures; 27% were OCV. Ossicular chain disruption, tympanic plate fracture, and ppneumolabyrinthCSF leak were present in 17.8%, 13.3%, and 8.9%, respectively. Concomitant craniofacial fractures occurred at 27%, chiefly Lefort III (15.6%) and Lefort II (8.9%). Transverse/mixed fractures were strongly associated with Lefort II–III injuries (χ² = 16.2, p = 0.001); age (p = 0.21) and sex (p = 0.08) were non-significant. Conductive, sensorineural, and mixed hearing loss affected 69%, 13%, and 18%; facial nerve palsy occurred in 58%. Inter-observer agreement was substantial to almost perfect for all imaging variables (κ = 0.77–0.92). Conclusions: Although longitudinal fractures predominated, over one-quarter breached the otic capsule and one-fifth followed transverse/mixed planes, configurations associated with higher odds of conductive deafness, facial nerve palsy, and complex mid-facial fractures. HRCT provides reliable characterization and should underpin comprehensive head-and-mid-face trauma protocols. Enhanced road safety policies and multidisciplinary trauma care are vital for reducing neuro-otologic morbidity in resource-limited settings. Full article