Objective:The aim of this study was to
evaluate the efficacy of hyperbaric oxygen (HBO) therapy as salvage
therapy in patients with idiopathic sudden sensorineural hearing loss
(ISSNHL) after failure of systemic therapy.
Methods:
Forty-eight consecutive patients with refractory ISSNHL were enrolled
retrospectively. All patients were given systemic steroid therapy by
tapered doses. In addition, forty-one patients received intratympanic
dexamethasone injection. Hearing outcomes were determined by recovery
rate according to Siegel's criteria and hearing gains in pure-tone
average (PTA) measured by audiometry before and after HBO therapy. The
effects of prognostic factors on hearing recovery were also evaluated.
Results: Thirteen (27%) patients responded to HBO therapy. The remaining 35 (73%)
patients did not show any improvement. After HBO therapy, significant
improvement was found in mean hearing thresholds at all frequencies.
Only the level of initial PTA level and gender were significantly
associated with recovery. Patients with severe hearing loss (≥70 dB) had
significantly better results.
Conclusion:
Salvage HBO therapy may be beneficial in patients with ISSNHL who failed
to recover by primary combined steroid therapy. Further hearing
recovery with salvage HBO therapy can be expected, particularly in
patients with PTA greater than 70 dB.
Fetterman BL, Saunders JE, Luxford WM. Prognosis and treat-
ment of sudden sensorineural hearing loss. Am J Otol 1996;17:
529–36.
2. Mattox DE, Simmons FB. Natural history of sudden sensorineur-
al hearing loss. Ann Otol Rhinol Laryngol 1977;86:463–80.
3. Rauch SD. Clinical practice: idiopathic sudden sensorineural hear-
ing loss. N Engl J Med 2008;359:833–40.
4. Li P, Zeng XL, Ye J, Yang QT, Zhang GH, Li Y. Intratympanic
methylprednisolone improves hearing function in refractory sud-
den sensorineural hearing loss: a control study. Audiol Neurootol
2011;16:198–202.
5. Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical practice
guideline: sudden hearing loss. Otolaryngol Head Neck Surg
2012;146(Suppl 3):S1–S35.
6. Gundogan O, Pinar E, Imre A, Ozturkcan S, Cokmez O, Yigiter
AC. Therapeutic efficacy of the combination of intratympanic
methylprednisolone and oral steroid for idiopathic sudden deaf-
ness. Otolaryngol Head Neck Surg 2013;149:753–8.
7. Battaglia A, Lualhati A, Lin H, Burchette R, Cueva R. A prospec-
tive, multi-centered study of the treatment of idiopathic sudden
sensorineural hearing loss with combination therapy versus high-
dose predisone alone: a 139 patient follow-up. Otol Neurotol
2014;35:1091–8.
8. Koltsidopoulos P, Bibas A, Sismanis A, Tzonou A, Seggas I.
Intratympanic and systemic steroids for sudden hearing loss. Otol
Neurotol 2013;34:771–6.
9. Hosokawa S, Sugiyama KI, Takahashi G, et al. Hyperbaric oxygen
therapy as adjuvant treatment for idiopathic sudden sensorineural
hearing loss after failure of systemic steroids. Audiol Neurootol
2017;22:9–14.
10. Yang CH, Wu RW, Hwang CF. Comparison of intratympanic
steroid injection, hyperbaric oxygen and combination therapy in
refractory sudden sensorineural hearing loss. Otol Neurotol 2013;
34:1411–6.
11. Nagahara K, Fisch U, Yagi N. Perilymph oxygenation in sudden
and progressive sensorineural hearing loss. Acta Otolaryngol 1983;
96:57–68.
12. Bennet MH, Kertesz T, Yeung P, Lehm JP. Hyperbaric oxygen
for idiopathic sudden sensorineural hearing loss and tinnitus.
Cochrane Database Syst Rev 2012:10;CD004739.
13. Cvorovic L, Jovanovic MB, Milutinovic Z, Arsovic N, Djeric D.
Randomized prospective trial of hyperbaric oxygen therapy and
intratympanic steroid injection as salvage treatment of sudden sen-
sorineural hearing loss. Otol Neurotol 2013;34:1021–6.
14. Pezzoli M, Magnano M, Maffi L, et al. Hyperbaric oxygen thera-
py as salvage treatment for sudden sensorineural hearing loss: a
prospective controlled study. Eur Arch Otorhinolaryngol
2015;272:1659–66.
15. Alimoglu Y, Inci E. Is hyperbaric oxygen therapy a salvage treat-
ment option for sudden sensorineural hearing loss? J Otol
Laryngol 2016;130:943–7.
16. Desloovere C, Knecht R, Germonpre P. Hyperbaric oxygen ther-
apy after failure of conventional therapy for sudden deafness. B-
ENT 2006;2:69–73.
17. Ohno K, Noguchi Y, Kawashima Y, Yagishita K, Kitamura K.
Secondary hyberbaric oxygen therapy for idiopathic sudden sen-
sorineural hearing loss in subacute and chronic phases. J Med Dent
Sci 2010;57:127–32.
18. Korpinar S, Alkan Z, Yigit O, et al. Factors influencing the out-
come of idiopathic sudden sensorineural hearing loss treated with
hyperbaric oxygen therapy. Eur Arch Otorhinolaryngol 2011;268:
41–7.
19. Suzuki H, Hashida K, Nguyen KH, et al. Efficacy of intratympanic
steroid administration on idiopathic sudden sensorineural hearing
loss in comparison with hyperbaric oxygen therapy. Laryngoscope
2012;122:1154–7.
20. Hart GB, Strauss MB. Gender differences in human skeletal mus-
cle and subcutaneous tissue gases under ambient and hyperbaric
oxygen conditions. Undersea Hyperb Med 2007;34:147–61.
Fetterman BL, Saunders JE, Luxford WM. Prognosis and treat-
ment of sudden sensorineural hearing loss. Am J Otol 1996;17:
529–36.
2. Mattox DE, Simmons FB. Natural history of sudden sensorineur-
al hearing loss. Ann Otol Rhinol Laryngol 1977;86:463–80.
3. Rauch SD. Clinical practice: idiopathic sudden sensorineural hear-
ing loss. N Engl J Med 2008;359:833–40.
4. Li P, Zeng XL, Ye J, Yang QT, Zhang GH, Li Y. Intratympanic
methylprednisolone improves hearing function in refractory sud-
den sensorineural hearing loss: a control study. Audiol Neurootol
2011;16:198–202.
5. Stachler RJ, Chandrasekhar SS, Archer SM, et al. Clinical practice
guideline: sudden hearing loss. Otolaryngol Head Neck Surg
2012;146(Suppl 3):S1–S35.
6. Gundogan O, Pinar E, Imre A, Ozturkcan S, Cokmez O, Yigiter
AC. Therapeutic efficacy of the combination of intratympanic
methylprednisolone and oral steroid for idiopathic sudden deaf-
ness. Otolaryngol Head Neck Surg 2013;149:753–8.
7. Battaglia A, Lualhati A, Lin H, Burchette R, Cueva R. A prospec-
tive, multi-centered study of the treatment of idiopathic sudden
sensorineural hearing loss with combination therapy versus high-
dose predisone alone: a 139 patient follow-up. Otol Neurotol
2014;35:1091–8.
8. Koltsidopoulos P, Bibas A, Sismanis A, Tzonou A, Seggas I.
Intratympanic and systemic steroids for sudden hearing loss. Otol
Neurotol 2013;34:771–6.
9. Hosokawa S, Sugiyama KI, Takahashi G, et al. Hyperbaric oxygen
therapy as adjuvant treatment for idiopathic sudden sensorineural
hearing loss after failure of systemic steroids. Audiol Neurootol
2017;22:9–14.
10. Yang CH, Wu RW, Hwang CF. Comparison of intratympanic
steroid injection, hyperbaric oxygen and combination therapy in
refractory sudden sensorineural hearing loss. Otol Neurotol 2013;
34:1411–6.
11. Nagahara K, Fisch U, Yagi N. Perilymph oxygenation in sudden
and progressive sensorineural hearing loss. Acta Otolaryngol 1983;
96:57–68.
12. Bennet MH, Kertesz T, Yeung P, Lehm JP. Hyperbaric oxygen
for idiopathic sudden sensorineural hearing loss and tinnitus.
Cochrane Database Syst Rev 2012:10;CD004739.
13. Cvorovic L, Jovanovic MB, Milutinovic Z, Arsovic N, Djeric D.
Randomized prospective trial of hyperbaric oxygen therapy and
intratympanic steroid injection as salvage treatment of sudden sen-
sorineural hearing loss. Otol Neurotol 2013;34:1021–6.
14. Pezzoli M, Magnano M, Maffi L, et al. Hyperbaric oxygen thera-
py as salvage treatment for sudden sensorineural hearing loss: a
prospective controlled study. Eur Arch Otorhinolaryngol
2015;272:1659–66.
15. Alimoglu Y, Inci E. Is hyperbaric oxygen therapy a salvage treat-
ment option for sudden sensorineural hearing loss? J Otol
Laryngol 2016;130:943–7.
16. Desloovere C, Knecht R, Germonpre P. Hyperbaric oxygen ther-
apy after failure of conventional therapy for sudden deafness. B-
ENT 2006;2:69–73.
17. Ohno K, Noguchi Y, Kawashima Y, Yagishita K, Kitamura K.
Secondary hyberbaric oxygen therapy for idiopathic sudden sen-
sorineural hearing loss in subacute and chronic phases. J Med Dent
Sci 2010;57:127–32.
18. Korpinar S, Alkan Z, Yigit O, et al. Factors influencing the out-
come of idiopathic sudden sensorineural hearing loss treated with
hyperbaric oxygen therapy. Eur Arch Otorhinolaryngol 2011;268:
41–7.
19. Suzuki H, Hashida K, Nguyen KH, et al. Efficacy of intratympanic
steroid administration on idiopathic sudden sensorineural hearing
loss in comparison with hyperbaric oxygen therapy. Laryngoscope
2012;122:1154–7.
20. Hart GB, Strauss MB. Gender differences in human skeletal mus-
cle and subcutaneous tissue gases under ambient and hyperbaric
oxygen conditions. Undersea Hyperb Med 2007;34:147–61.
İmre, A., Aladağ, İ., Pınar, E., Aslan, H., vd. (2017). Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids. ENT Updates, 7(3), 120-125.
AMA
İmre A, Aladağ İ, Pınar E, Aslan H, Duran R, Yazır M. Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids. ENT Updates. Kasım 2017;7(3):120-125.
Chicago
İmre, Abdulkadir, İbrahim Aladağ, Ercan Pınar, Hale Aslan, Rıdvan Duran, ve Mustafa Yazır. “Therapeutic Efficacy of Salvage Hyperbaric Oxygen Therapy in Sudden Sensorineural Hearing Loss After Failure of Steroids”. ENT Updates 7, sy. 3 (Kasım 2017): 120-25.
EndNote
İmre A, Aladağ İ, Pınar E, Aslan H, Duran R, Yazır M (01 Kasım 2017) Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids. ENT Updates 7 3 120–125.
IEEE
A. İmre, İ. Aladağ, E. Pınar, H. Aslan, R. Duran, ve M. Yazır, “Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids”, ENT Updates, c. 7, sy. 3, ss. 120–125, 2017.
ISNAD
İmre, Abdulkadir vd. “Therapeutic Efficacy of Salvage Hyperbaric Oxygen Therapy in Sudden Sensorineural Hearing Loss After Failure of Steroids”. ENT Updates 7/3 (Kasım 2017), 120-125.
JAMA
İmre A, Aladağ İ, Pınar E, Aslan H, Duran R, Yazır M. Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids. ENT Updates. 2017;7:120–125.
MLA
İmre, Abdulkadir vd. “Therapeutic Efficacy of Salvage Hyperbaric Oxygen Therapy in Sudden Sensorineural Hearing Loss After Failure of Steroids”. ENT Updates, c. 7, sy. 3, 2017, ss. 120-5.
Vancouver
İmre A, Aladağ İ, Pınar E, Aslan H, Duran R, Yazır M. Therapeutic efficacy of salvage hyperbaric oxygen therapy in sudden sensorineural hearing loss after failure of steroids. ENT Updates. 2017;7(3):120-5.