Background: Tramadol is a centrally acting opioid with an analgesic effect. Prolonged chronic pain management with tramadol and tramadol misuse may cause opioid use disorder attributed to tramadol (OUD-T). Evidence from pathophysiologic mechanisms of OUD-T raised the probability for central auditory processing abnormalities. Objectives: To our knowledge, no available studies evaluate the underlying pathology. Consequently, this study was designed to evaluate speech recognition, auditory temporal processing, auditory neurocognitive function in these patients. Materials and Methods: This work comprised a study group of 19 males with OUD-T and a control group of 19 participants, both with an age range of 20-40 years. All participants were subjected to (1) basic audiological evaluation, (2) psychoacoustic central auditory tests to assess auditory figure ground (speech intelligibility in noise) and temporal processing (Gaps-In-Noise and pitch pattern sequence), and (3) P300 neurocognitive potential. Results:OUD-T showed statistical significant depressed scores of speech in noise and pitch pattern sequence tests in comparison to the control group. In addition a statistically significant elevated GIN test approximate threshold and depressed total score was present in OUD-T. As regards P300, there was statistically significant difference between the control and the study group in latency and amplitude. Conclusion:These findings emphasize the importance of speech in noise, temporal processing, and neurocognitive evaluation in adults with opioid use disorder attributed to tramadol.Keywords: Auditory figure-ground, gaps-in-noise test, opioid use disorder attributed to tramadol, P300, pitch pattern sequence, temporal auditory processing Address for correspondence:Dr. Nadia Mohamed Elnabtity, Department of Otolaryngology‑Head and Neck Surgery, Audio‑Vestibular Medicine Unit, Faculty of Medicine, University of Zagazig, Zagazig, Egypt. E‑mail: nadiaelnabtity@gmail.com Access this article online Quick Response Code: Website: https://journals.lww.com/ijoo DOI: 10.4103/indianjotol.indianjotol_84_23 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact:WKHLRPMedknow_reprints@wolterskluwer.com How to cite this article: Elnabtity NM, Ibraheem OA, Galhom DH. Temporal auditory processing, speech recognition, and P300 in adults with opioid use disorders attributed to tramadol. Indian J Otol 2023;29:239-45. Temporal Auditory Processing, Speech Recognition, and P300 in Adults with Opioid Use Disorders Attributed to Tramadol Nadia Mohamed Elnabtity, Ola Abdallah Ibraheem, Dalia Helal Galhom Department of Otolaryngology‑Head and Neck Surgery, Audio‑Vestibular Medicine Unit, Faculty of Medicine, University of Zagazig, Zagazig, Egypt Submitted: 10‑Jul‑2023 Accepted:09‑Nov‑2023 Published: 30‑Dec‑2023 Downloaded from http://journals.lww.com/ijoo by zMRKLGh+lXHYs1gJw