{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:04:54Z","timestamp":1760058294013,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T00:00:00Z","timestamp":1742688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The management of chronic tinnitus in patients with otosclerosis presents a considerable clinical challenge, particularly as to those who are either ineligible for or reluctant to undergo surgical interventions. Surgical interventions improve hearing levels and may provide relief from tinnitus; however, medical research is also focused on alternative non-surgical treatments aimed at symptomatic improvement. This is particularly relevant, considering that otosclerosis currently has no definitive cure, despite the existence of various surgical techniques and oral therapies. This study evaluates the effects of oral calcium and fluoride supplementation on tinnitus severity in otosclerosis patients who opted for non-surgical management. Materials and Methods: A total of 128 otosclerosis patients with tinnitus were included in this study, which was conducted over a five-year period. Patients were categorized into three groups based on the severity of their tinnitus (mild, moderate and severe), as assessed by the Tinnitus Handicap Inventory (THI). Patients in all three groups received Florical (Mericon Industries, Inc., Peoria, IL, USA), a calcium and fluoride supplement, and were monitored over three months. The severity of tinnitus was reassessed following supplementation. Statistical analyses were conducted to further investigate patient scores. Results: Evaluating patients based on the severity of their tinnitus, we consistently observed clinically significant reductions in THI scores, specifically a decrease of 10 points or more, among those with mild tinnitus. The moderate group exhibited a lower degree of reduction in their THI scores, while the severe group appeared to be unaffected. Statistical analyses reveal a significant correlation between the reduction of tinnitus and the supplementation of Florical, as the severity of tinnitus decreases. Conclusions: The present study suggests that oral calcium and fluoride supplementation may serve as a promising non-surgical approach for tinnitus management in otosclerosis (particularly in patients with mild symptoms), in addition to its marketing-indicated role, supporting the preservation of hearing levels in otosclerosis. Its efficacy seems to diminish as tinnitus severity increases, further pointing out a potential preventative role of this supplementation.<\/jats:p>","DOI":"10.3390\/medicina61040569","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T13:48:20Z","timestamp":1742824100000},"page":"569","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Clinical Evaluation of Calcium and Fluoride Supplementation for Tinnitus in Non-Surgical Otosclerosis: Insights from a Tertiary Care Center in Romania"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-3789","authenticated-orcid":false,"given":"Andrei","family":"Osman","sequence":"first","affiliation":[{"name":"Department of Anatomy and Embriology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Otorhinolaringology Department, Emergency County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice Elena","family":"Ghenea","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Clinical Laboratory, Emergency County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-3838","authenticated-orcid":false,"given":"Ovidiu Mircea","family":"Zlatian","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Clinical Laboratory, Emergency County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4817-1365","authenticated-orcid":false,"given":"Lidia","family":"Boldeanu","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Clinical Laboratory, Emergency County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Enache","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Embriology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Otorhinolaringology Department, Emergency County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madalina Gabriela","family":"Georgescu","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Qualified Care in Surgical Specialties, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen Aurelia","family":"Mogoanta","sequence":"additional","affiliation":[{"name":"Otorhinolaringology Department, Emergency County Hospital of Craiova, 200642 Craiova, Romania"},{"name":"Department of Otorhinolaryngology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/01.mao.0000187050.04286.80","article-title":"Adam Politzer (1835\u20131920) and the description of otosclerosis","volume":"27","author":"Mudry","year":"2006","journal-title":"Otol. 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