Idiopathic sudden onset sensorineural hearing loss (SSNHL) is a relatively common presentation to the ENT emergency department, and can have profound effects on patients’ lives. This retrospective study looked at 15 patients who were treated with hyperbaric oxygen after failure of steroid and vasodilator therapy. The hyperbaric oxygen was given with a mean delay of 24 days after the onset of SSNHL and involved 15 sessions. The results were compared with a control group of 30 patients who only received steroid and vasodilator treatment. Pure tone audiometry was performed prior to treatment and at three months post-treatment. The mean gain in the hyperbaric group was 12.1dB which was significantly better than that in the control group of 2.7dB, and was found to be better at the lower frequencies. Hyperbaric oxygen has been shown in previous studies to increase the partial pressure of oxygen in the inner ear fluids of the cochlea. This study tries to explain the apparent improvement in hearing at lower frequencies because the hair cells at the apical turn of the cochlea (representing the lower frequencies) are more sensitive to changes in the partial pressure of oxygen. The paper concludes that there is no exact time limitation for hyperbaric oxygen treatment, although the American Academy of Otolaryngology-Head and Neck Surgery recommend commencing treatment within three months of diagnosis. This paper highlights possible benefits of using salvage hyperbaric oxygen therapy for SSNHL (which carries few risks), but the relatively few hyperbaric oxygen centres in the UK may limit its widespread use.
Hyperbaric oxygen for sudden onset sensorineural hearing loss
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