Hyperbaric Oxygen Therapy for Sudden Hearing Loss after Failure of Intratympanic and Oral Corticosteroid Therapy

Abstract

Objectives: Determine the efficacy of hyperbaric oxygen therapy (HBOT) in idiopathic sudden sensorineural hearing loss (ISSHL) after unsuccessful treatment with oral and intratympanic corticosteroids. The current treatment for ISSHL remains controversial. Systemic and intratympanic steroids are usually prescribed; unfortunately, only 61% of patients achieve full recovery. Recently, hyperbaric oxygen therapy has emerged as a new possible treatment. Methods: Case series at a secondary care center. Patients were included from March 2013 to July 2013. Inclusion criteria: age >18 years, failure to systemic and intratympanic corticosteroids. Ten sessions of HBOT were conducted, 60 minutes each, at 2 atmospheres. All patients underwent audiometry before and after treatment. Pure tone average (PTA) was defined as the average of the frequencies of 500, 1000, 2000, and 4000 Hz. Results: We included 4 female patients, mean age 51 years. The mean time from onset of illness to HBOT was 108.75 days. Initial mean PTA was 55.31 dB, final PTA was 54.6875 dB ( P = .958). Mean hearing gain was 0.625 dB. One patient had complete hearing recovery, 2 patients slight improvement (recovery of 3.75 dB), and 1 patient worsened. Two patients reported subjective improvement of dizziness. Although hearing gain was observed at low frequencies in 2 patients (25 dB and 20 dB), no statistical significance was achieved ( P = .817). No complications were reported. Conclusions: The use of HBOT in patients who fail steroid therapy did not demonstrate a beneficial hearing effect in ISSHL patients. However, symptoms such as dizziness improved subjectively. More studies are needed to corroborate our results.