The use of hyperbaric oxygen therapy in acute hearing loss: a narrative review

A B Bayoumy,J A De Ru

doi:10.1007/s00405-019-05469-7

Abstract

IntroductionAcute hearing loss can have a major impact on a patient’s life. This holds true for both acute acoustic trauma (AAT) and idiopathic sudden sensorineural hearing loss (ISSHL), two devastating conditions for which no highly effective treatment options exist. This narrative review provides the rationale and evidence for HBOT in AAT and ISSHL.MethodsNarrative review of all the literature available on HBOT in acute hearing loss, studies were retrieved from systematic searches on PubMed and by cross referencing.DiscussionFirst, the etiological mechanisms of acute hearing loss and the mechanism of action of HBOT were discussed. Furthermore, we have provided an overview of 68 studies that clinically investigated the effect of HBOT in the last couple of decades. For future studies, it is recommend to start as early as possible with therapy, preferably within 48 h and to use combination therapy consisting of HBOT and corticosteroids.Implications for practiceHBOT has been used quite extensively for acute hearing loss in the last couple of decades. Based on the amount of studies showing a positive effect, HBOT should be discussed with patients (shared decision making) as optional therapy in case of AAT and ISSHL.

Highlights

Acute hearing loss can have a major impact on a patient’s life. This holds true for both acute acoustic trauma (AAT) and idiopathic sudden sensorineural hearing loss (ISSHL), two devastating conditions for which no highly effective treatment options exist [1, 2]
In 2008, Ylikoski et al published the results of a study in which hyperbaric oxygen therapy (HBOT) monotherapy was compared to normobaric oxygen therapy in a cohort of AAT patients, who were exposed to firearm shooting
Lafère et al found significantly higher hearing gains in the HBOT groups of patients suffering from AAT that started therapy within 6–43 h compared to the control group that received corticosteroid therapy within 48 h [103]

Summary

Introduction

Acute hearing loss can have a major impact on a patient’s life. This holds true for both acute acoustic trauma (AAT) and idiopathic sudden sensorineural hearing loss (ISSHL), two devastating conditions for which no highly effective treatment options exist [1, 2]. In 2008, Ylikoski et al published the results of a study in which HBOT monotherapy was compared to normobaric oxygen therapy in a cohort of AAT patients, who were exposed to firearm shooting They reported significantly higher hearing gains in the HBOT group compared to the normobaric group (69.3 vs 56.2%, P < 0.001) [78]. Lafère et al found significantly higher hearing gains in the HBOT groups of patients suffering from AAT that started therapy within 6–43 h compared to the control group that received corticosteroid therapy within 48 h [103] In line with these results, Bayoumy et al [126] concluded that early initiation within 2 days of acoustic trauma with HBOT had significantly higher relative hearing gain compared to the same treatment started after 2 days.

Study design Medical therapy

PF vs HBOT

Conclusion

Compliance with ethical standards