Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: a prospective controlled study

Abstract

The most commonly used treatment for sensorineural sudden hearing loss (SSHL) in clinical practice is the administration of steroids; however, a favorable result is not always obtained. We studied 58 patients who failed to recover after primary treatment with IV steroids, 44 of these met our inclusion criteria (mean age 50.7, 27 males, range 30-74). We treated 23 patients (mean age 47.3, 16 males, age range 22-74) with hyperbaric oxygen therapy (HBO) (2.5 ATA for 60 min for 15 treatments), while 21 (mean age 54.5, 11 males, age range 22-71) patients refused to be treated and served as a non-randomized control group. Patients treated with HBO had a mean improvement of 15.6 dB (SD ± 15.3), with 1 of them completely healed, 5 with a good recovery, 10 with a fair recovery and 7 unchanged. Patients who were not treated had a spontaneous mean improvement of 5.0 dB (SD ± 11.4) with 3 patients with a good recovery, 1 patient with a fair recovery and 17 patients unchanged. Mean improvement was significantly better in patients treated with HBO compared to controls (p = 0.0133). Patients with worst hearing had the greater degree of improvement whether or not they were treated in the first 10 days after the onset of the hearing loss or between 11 and 30 days. In conclusion, hyperbaric oxygen therapy can lead to significant improvement of pure tone hearing thresholds in patients with SSHL who failed primary corticosteroid treatment and are within 4 weeks of the onset of deafness.

Hyperbaric Oxygen Therapy as Salvage Therapy for Sudden Sensorineural Hearing Loss

“…While previous studies showed that younger patients had better response after HBO therapy, in our study, we found no hearing improvement related to age. Our study showed that HBO therapy as salvage therapy significantly improves the outcome in patients with a hearing loss of >61 dB, while some previous studies have found the benefit of HBO therapy only among patients presenting with profound hearing loss (>80 or >90 dB) [19,21,22] . In the group of patients with a hearing loss of ≤60 dB, improvement was noticed only at low frequencies (0.25 and 0.5 kHz), which is consistent with a previous study on SSNHL that showed that the apical part of the cochlea recover better than the basal parts [24] .…”

“…The most commonly used salvage therapies for sudden hearing loss are HBO therapy and intratympanic steroid therapy [17][18][19][20][21] . A comparison of these two methods was recently described [22,23] .…”

Our results on sudden hearing loss and hyperbaric oxygen therapy role in recovery

“…Kesin kontrendikasyon oluşturan pnömotoraks ve rölatif kontendikasyon oluşturan yüksek ateş, optik nörit, gebelik, kalp ve solunum yetmelikleri, otit ve sinüzit varlığı dışında tüm hastalara uygulabilmektedir. HBO2, steroidlerle kombine ve steroid tedavisine cevap vermeyen olgularda ise kurtarma tedavisi olarak kullanıldığı bildirilmiştir [19]. Ancak ilk 48 saatte tedaviye başlamanın daha yaralı olduğu kabul edilmektedir [20].…”

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

“…[12] Although prospective clinical trials of salvage HBO therapy with a control group are limited, result of these studies showed some benefits in hearing improvement. [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.…”

“…[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.…”