Hyperbaric Oxygen Therapy as Adjuvant Treatment for Idiopathic Sudden Sensorineural Hearing Loss after Failure of Systemic Steroids

Abstract

We evaluated the outcomes of and prognostic factors for idiopathic sudden sensorineural hearing loss (ISSNHL) treated with adjuvant hyperbaric oxygen therapy (HBOT). A retrospective review of clinical data was performed for 167 patients with ISSNHL who failed to respond to systemic steroids and were treated by adjuvant HBOT at Shizuoka Saiseikai General Hospital. We analysed the clinical outcomes, the averaged 5-frequency hearing level after systemic steroids, patient age, the interval between post-steroids and pre-HBOT, vertigo as a complication, the presence of diabetes mellitus, smoking history, and hypertension. Overall, after HBOT, complete recovery occurred in 16 (9.6%) of the patients, with definite improvement in 16 (9.6%) and slight improvement in 45 (26.9%). The overall rate of hearing improvement was higher in the study group (77/167 cases, 46.1%) than in the control group (52/160 cases, 32.5%; p = 0.021). If performed appropriately, HBOT should be able to improve hearing in many cases unresponsive to initial therapy.

Hyperbaric Oxygen Therapy as Concurrent Treatment with Systemic Steroids for Idiopathic Sudden Sensorineural Hearing Loss: A Comparison of Three Different Steroid Treatments

“…In the present study, the hearing recovery rate was not influenced by the patient age, presence of concomitant systemic diseases (diabetes mellitus and hypertension), or other prognostic factors except for the presence of vertigo, as discussed in our previous study [Hosokawa et al, 2017a]. One limitation of this study is that we measured the hearing thresholds during the time course of treatment and showed the absolute hearing gain value; however, we did not evaluate speech perception, which reflects actual improvements in the quality of life [Pezzoli et al, 2015].…”

“…HBOT and SS, hyperbaric oxygen therapy combined with systemic steroid therapy; IT and SS, intratympanic steroids combined with systemic steroid therapy; SS alone, systemic steroid therapy only; CR, complete recovery; GI, good improvement; FI, fair improvement; NC/DR, no change or deterioration. onset of symptoms and treatment initiation, as described in our previous study [Hosokawa et al, 2017a]: ≤7 days and > 7 days. The average times to start therapy in each group are 4.5 days in the HBOT + SS, 4.5 days in the SS alone, and 14.5 days in the IT + SS group, respectively.…”

Addition of Hyperbaric Oxygen Therapy vs Medical Therapy Alone for Idiopathic Sudden Sensorineural Hearing Loss

“…Among other subgroups of the statistical model and the time point of response assessment, the benefit of HBOT on complete hearing recovery was similar. For any hearing recovery, the favorable results of the HBOT + MT group compared Odds ratios (OR) with 95% CIs are shown by individual studies describing pooled overall benefits for complete hearing recovery 7,[10][11][12][13][14][15][16][18][19][20][21][22]24 (A) and for any hearing recovery 7,[10][11][12][13][14][15][16][17][18][19][20][21][22]24 with the MT alone group were consistent across all subgroups (eFigure 3 in the Supplement).…”

Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids

“…ITS or HBO therapy applied either as salvage or adjuvant therapy for ISSNHL has shown positive results in terms of hearing improvements. [9] But there is still ongoing controversy about which salvage therapy is better. Furthermore, to the best of our knowledge, there is very limited data regarding the efficacy of HBO therapy following combined steroid (systemic+ITS) treatment.…”

“…[10,13,14] The results of salvage HBO therapy in previous studies are demonstrated in Table 4. [9,[14][15][16][17][18] To date, no reports have been published about the hearing outcomes of salvage HBO therapy after combined steroid treatment. The results of this study indicate that there is still something to do after combined steroid treatment in ISSNHL.…”