Sudden sensorineural hearing loss: role of hyperbaric oxygen therapy

Abstract

Sudden sensorineural hearing loss is defined as an acute hearing reduction of 30 dB or more, in at least three consecutive frequencies, occurring within 3 days of symptom onset. There is no consensus on the best treatment option. The aims of this paper were to evaluate the effectiveness of a treatment protocol based on medical therapy combined with hyperbaric oxygen therapy and to examine the factors that influence the recovery of hearing (age, gender, the amount of time between the onset of symptoms and the initiation of treatment -time since onset -, audiometric curve type and objective vertigo). Audiometric results were evaluated according to Siegel's criteria. In patients treated also with hyperbaric oxygen therapy we observed complete resolution in 44.1% of the patients, partial resolution in 37.2%, slight improvement in 10.5% and no improvement in 8.2% of the patients. This resolution pattern was significantly different from that observed in the patients treated only with medical therapy. The factors associated with a better prognosis were young age, rapid intervention, upward sloping or pantonal audiometric patterns and the absence of objective vertigo. Gender appeared to be an insignificant factor. Medical treatment associated with hyperbaric oxygen therapy gives better results in terms of hearing gain compared to exclusive medical treatment.

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

“…Odds ratios (OR) with 95% CIs are shown by individual studies describing pooled overall benefits for complete hearing recovery (A) and for any hearing recovery (B). MT indicates medical therapy.…”

“…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).…”

“…1 As another option, HBOT is a treatment that may relieve edema and ischemia by administering high-pressure oxygen into the inner ear to restore hearing. 4 Since the first case report 5 of HBOT for SSNHL treatment in the 1960s, a number of randomized clinical trials (RCTs) [6][7][8] and nonrandomized studies [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] investigating the benefit of HBOT have been reported. As an adjunctive treatment to standard medical therapy (MT) that includes systemic corticosteroids, HBOT has been found to promote hearing gain.…”