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HBO2 for sudden sensorineural hearing loss.

Tracy Leigh LeGros1, Heather Murphy-Lavoie1

  • 1Clinical Professor, Section of Emergency Medicine, Louisiana State University, University Medical Center, New Orleans, Louisiana U.S.

Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc
|June 24, 2020
PubMed
Summary

Sudden sensorineural hearing loss (SSNHL) treatment combining corticosteroids and hyperbaric oxygen (HBO2) therapy offers significant hearing recovery. Early intervention within 14 days yields the best outcomes for idiopathic SSNHL patients.

Keywords:
hyperbaric oxygenidiopathic sensorineural hearing losssteroid

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Area of Science:

  • Otolaryngology
  • Neurology
  • Hyperbaric Medicine

Background:

  • Sudden sensorineural hearing loss (SSNHL) is often idiopathic, with hypoxia of the organ of Corti as a common pathological result.
  • Hair cell damage, synaptic dysfunction, and sustained depolarization are key features of SSNHL.
  • Corticosteroids and hyperbaric oxygen (HBO2) therapy are the only treatments proven effective in randomized controlled trials (RCTs).

Purpose of the Study:

  • To review the pathophysiology of SSNHL.
  • To evaluate various treatments for SSNHL, focusing on HBO2 and corticosteroids.
  • To present evidence for the combined use of HBO2 and corticosteroids in treating SSNHL.

Main Methods:

  • Review of retrospective case-controlled and prospective randomized controlled studies.
  • Analysis of treatment protocols for HBO2 (2-2.5 ATA, 90 min, 10-20 sessions) and corticosteroids (1mg/kg/day, tapered).
  • Inclusion of intratympanic (IT) steroid protocols as an alternative to systemic steroids.

Main Results:

  • Combined HBO2 and corticosteroid therapy initiated within 14 days shows optimal results.
  • Significant hearing improvement observed: 37.7 dB for severe loss, 19.3 dB for moderate loss, and 15.6 dB overall.
  • IT steroids combined with HBO2 provide good outcomes for patients unsuitable for systemic steroids.

Conclusions:

  • Combined HBO2 and corticosteroid therapy is the most effective treatment for SSNHL.
  • Early treatment initiation (within 14 days) is crucial for maximizing hearing recovery.
  • HBO2 therapy significantly restores hearing, potentially eliminating the need for hearing aids and sign language.