Adjunctive Hyperbaric Oxygen Therapy or Intratympanic Steroids in Sudden Sensorineural Hearing Loss?

Area of Science:

• Otolaryngology
• Audiology
• Hyperbaric Medicine

Background:

• Sudden sensorineural hearing loss (SSNHL) pathophysiology remains unclear, leading to debated treatment strategies.
• Traditional treatments include oral corticosteroids (OCS) and/or intratympanic steroid injections (ITSI).
• Hyperbaric oxygen treatment (HBOT) is increasingly used as an adjunctive therapy for SSNHL.

Purpose of the Study:

• To investigate the additive effect of HBOT combined with traditional steroid treatment for SSNHL.
• To compare treatment outcomes between patients receiving HBOT + ITSI versus ITSI alone.

Main Methods:

• Retrospective study involving 119 patients with SSNHL.
• Comparison of pure tone average (PTA), speech recognition threshold (SRT), and word recognition score (WRS) between ITSI and HBOT + ITSI groups.
• Sub-analysis of responders, nonresponders, treatment delay, and number of injections/dives.

Main Results:

• Both groups showed significant pre- to post-treatment improvement in PTA, SRT, and WRS.
• No significant difference in improvement was observed between the ITSI and HBOT + ITSI groups.
• Patients refractory to oral corticosteroids (OCS) were more likely to be nonresponders to treatment.
• A subset of patients refractory to ITSI alone showed audiometric improvement after HBOT.

Conclusions:

• Adjunctive HBOT did not provide additional treatment benefit for SSNHL when combined with ITSI.
• HBOT may be beneficial for SSNHL patients refractory to steroid treatment.
• No additional benefit was observed with more than 23 HBOT dives; treatment evaluation is complex due to confounding factors.