Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: review of rationale and preliminary report

Muzzi, Enrico; Zennaro, B; Visentin, Renea; Soldano, Franca; Sacilotto, C

doi:10.1017/s0022215109992052

Cited by 39 publications

(38 citation statements)

References 48 publications

(123 reference statements)

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“…There have been several reports of HBOT being used with different options and durations in the treatment of ISSNHL [Dundar et al, 2007;Fujimura et al, 2007;Muzzi et al, 2010]. There is still no universally accepted approach for routine clinical application or clear information on the effectiveness of HBOT in these patients.…”

Section: Discussionmentioning

confidence: 99%

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

Hosokawa

Sugiyama²,

Takahashi³

et al. 2017

Audiol Neurotol

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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.

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Section: Discussionmentioning

confidence: 99%

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

Hosokawa

Sugiyama²,

Takahashi³

et al. 2017

Audiol Neurotol

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“…Although costs may vary considerably among facilities, queries by the committee showed that typical Younger patients respond better to hyperbaric oxygen therapy (HBOT) than older patients (the age cutoffs varied from 50-60 years). 173,[235][236][237][238] Early HBOT is better than late HBOT (early is defined from 2 weeks to 3 months). 173,177,235,236,[238][239][240][241] Patients with moderate to severe hearing loss benefit more from HBOT than those with mild hearing loss (moderate hearing loss cutoff was usually at 60 dB).…”

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline

Stachler

Chandrasekhar

Archer

et al. 2012

Otolaryngol.--head neck surg.

771

355

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Objective. Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL.Purpose. The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients.Results. The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals,...

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“…18,19 Muzzi et al reported that salvage HBO therapy was effective especially at low frequencies and in older patients. 20 On the other hand, every patient may not tolerate HBO treatment. In addition, HBO therapy must be discontinued if side effects occur.…”

Section: Discussionmentioning

confidence: 99%

Intratympanic Methyl Prednisolone Salvage Therapy for Sudden Hearing Loss

Hıdır¹,

Genç²,

Durmaz³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of the study was to determine effectiveness of intratympanic methyl prednisolone injection as a salvage therapy for sudden sensorineural hearing loss in patients who did not have complete recovery with systemic treatment. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: Sixteen patients with sudden hearing loss who did not have complete recovery or had a partial recovery with systemic treatment enrolled in this prospective study. After the topical anesthesia, 0.4-0.5 mL of methyl prednisolone (40 mg/mL) was administered into the middle ear from the postero-inferior quadrant of the tympanic membrane. Pure tone audiometry test was performed before each injection and after the final injection. A change more than 10 dB in the pure tone average was considered as an alteration in hearing (improvement or worsening). Complete recovery was accepted when the pure tone average was 20 dB or lower. R Re es su ul lt ts s: : The mean onset of intratympanic methyl prednisolone treatment after the hearing loss was 16±6.6 days (range: 7 -30 days). The average number of injections was 3.8±1.3 (range: 2-6). The improvement in pure tone average was statistically significant [initial median of pure tone average was 85 dB (minimum 28 dB, maximum 107 dB), final median of pure tone averages was 42.5 dB (minimum 12 dB, maximum 107dB), p=0.007]. Eleven (68.75%) patients improved, but no change was observed in 5 (31.25%) patients. Two (12.5%) patients attained complete recovery. Four (25%) patients improved to 30 dB or less in pure tone average. Statistically significant improvement was also obtained at 250, 500, 1,000, 2,000, 4,000 and 6,000 Hz frequencies. C Co on nc cl lu us si io on n: : These results suggested that intratympanic methyl prednisolone treatment for sudden hearing loss in patients who did not respond to systemic therapy appears to be a good alternative for better hearing results. K Ke ey y W Wo or rd ds s: : Hearing loss, sudden; methylprednisolone; salvage therapy; steroids Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, sistemik tedaviye yeterli yanıt alınamayan ani işitme kayıplı hastalarda kurtarma tedavisi olarak uygulanan intratimpanik metil prednizolon tedavisinin etkinliğini araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu prospektif çalışmaya, sistemik tedaviye yanıt alınamayan veya kısmi yanıt alınan 16 ani işitme kayıplı hasta alındı. Topikal anestezi sonrasında 0,4-0,5 mL metil prednizolon (40 mg/mL), timpanik membran posteroinferior kadranından orta kulağa enjekte edildi. Her enjeksiyon öncesinde ve tedavi sonunda saf ses odyometri testi yapıldı. Saf ses ortalamasında 10 desibelden daha fazla değişiklik, değişim olarak kabul edildi (iyileşme veya kötüleşme). Saf ses ortalamasının 20 dB ve daha aşağıdaki değerleri tam iyileşme olarak kabul edildi. B Bu ul lg gu ul la ar r: : İşitme kaybı başlangıcı ile intratimpanik metil prednizolon uygulaması arasındaki ortalama süre 16±6,6 gündü (7-30 gün arasında). Ortalama en...

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Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: review of rationale and preliminary report

Cited by 39 publications

References 48 publications

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

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

Clinical Practice Guideline

Intratympanic Methyl Prednisolone Salvage Therapy for Sudden Hearing Loss

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