Abstract
In our controlled retrospective analysis of medical records in tertiary care academic medical center, we aimed to investigate the therapeutic effects of hyperbaric oxygen (HBO) therapy combined with steroid administration for idiopathic sudden sensorineural hearing loss (ISSNHL) in comparison with that of steroid administration alone. Our subjects were 130 consecutive inpatients with ISSNHL (hearing levels ≥40 dB; time from the onset of hearing loss to the start of treatment ≤30 days). Sixty-seven patients underwent HBO plus steroid therapy (HBO group), and 63 were given steroids alone (steroid group). Hearing recovery was evaluated by grade assessment and by the improvement in hearing compared to that in the unaffected contralateral ear. The cure rate and hearing improvement rate were not statistically different between the two groups; however, the recovery rate was significantly higher in the HBO group than in the steroid group (59.7% vs. 39.7%; P < 0.05). With regard to patients with initial hearing levels of ≥80 dB, the hearing improvement rate was significantly higher in the HBO group than in the steroid group (51.1 ± 7.0% vs. 27.1 ± 7.8%; P < 0.05), while in patients whose initial hearing levels were <80 dB, hearing outcomes were not statistically different between the two groups. In both the HBO and steroid groups, patients with initial hearing levels of <80 dB showed a better hearing improvement rate than those with initial hearing levels of ≥80 dB. In conclusion HBO therapy shows a significant additional effect in combination with steroid therapy for ISSNHL, particularly in patients with severe hearing loss.
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Eisenman DJ, Arts HA (2000) Effectiveness of treatment for sudden sensorineural hearing loss. Arch Otolaryngol Head Neck Surg 126:1161–1164
Wilson WR, Byl FM, Laird N (1980) The efficacy of steroids in the treatment of idiopathic sudden hearing loss. a double-blind clinical study. Arch Otolaryngol 106:772–776
Boerema I, Meyne NG, Brummelkamp WH, Bouma S, Mensch MH, Kamermans F, Stern HM, von Aalderen (1960) Life without blood: a study of the influence of high atmospheric pressure and hypothermia on dilution of the blood. J Cardiovasc Surg 1:133–146
Appaix A, Demard F (1970) Hyperbaric oxygenotherapy and sudden perceptive deafness. Rev Laryngol Otol Rhinol (Bord) 91:951–972
Lamm H, Kimpel L (1971) Hyperbaric oxygen therapy in internal ear and vestibular disorders. Preliminary report. HNO 19:363–369
Vincey P (1978) Application and use of hyperbaric oxygenation in ENT. Rev Laryngol Otol Rhinol (Bord) 99:619–634
Goto F, Fujita T, Kitani Y, Kanno M, Kamei T, Ishii H (1979) Hyperbaric oxygen and stellate ganglion blocks for idiopathic sudden hearing loss. Acta Otolaryngol 88:335–342
Kanzaki J, Taiji H, Ogawa K (1988) Evaluation of hearing recovery in sudden and efficacy of steroid treatment in sudden deafness. Acta Otolaryngol Suppl 456:31–36
Suzuki H, Furukawa M, Kumagai M, Takahashi E, Matsuura K, Katori Y, Shimomura A, Kobayashi T (2003) Defibrinogenation therapy for idiopathic sudden sensorineural hearing loss in comparison with high-dose steroid therapy. Acta Otolaryngol 123:46–50
Melby JC (1974) Systemic corticosteroid therapy: pharmacology and endocrinologic considerations. Ann Intern Med 81:505–512
Kau RJ, Sendtner-Gress K, Ganzer U, Arnold W (1997) Effectiveness of hyperbaric oxygen therapy in patients with acute and chronic cochlea disorders. ORL J Otorhinolaryngol Relat Spec 59:79–83
Horn CE, Himel HN, Selesnick SH (2005) Hyperbaric oxygen therapy for sudden sensorineural hearing loss: a prospective trial of patients failing steroid and antiviral treatment. Otol Neurotol 26:882–889
Nakashima T, Fukuta S, Yanagita N (1998) Hyperbaric oxygen therapy for sudden deafness. Adv Otorhinolaryngol 54:100–109
Racic G, Maslovara S, Roje Z, Dogas Z, Tafra R (2003) Hyperbaric oxygen in the treatment of sudden hearing loss. ORL J Otorhinolaryngol Relat Spec 65:317–320
Aslan I, Oysu C, Veyseller B, Baserer N (2002) Does the addition of hyperbaric oxygen therapy to the conventional treatment modalities influence the outcome of sudden deafness? Otolaryngol Head Neck Surg 54:121–126
Narozny W, Sicko Z, Przewozny T, Stankiewicz C, Kot J, Kuczkowski J (2004) Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy in sudden sensorineural hearing loss. Otol Neurotol 25:916–923
Fattori B, Berrettini S, Casani A, Nacci A, DeVito A, DeIaco G (2001) Sudden hypoacusis treated with hyperbaric oxygen therapy: a controlled study. Ear Nose Throat J 80:655–660
Topuz E, Yigit O, Cinar U, Seven H (2004) Should hyperbaric oxygen be added to treatment in idiopathic sudden sensorineural hearing loss? Eur Arch Otorhinolaryngol 261:393–396
Schweinfurth JM, Parnes SM, Very M (1996) Current concepts in the diagnosis and treatment of sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 253:117–121
Chao TK (2004) Sudden sensorineural hearing loss after rapid reduction of blood pressure in malignant hypertension. Ann Oto Rhinol Laryngol 113:73–75
Lee H, Ahn BH, Baloh RW (2004) Sudden deafness with vertigo as a sole manifestation of anterior inferior cerebellar artery infarction. J Neurol Sci 222:105–107
Patzak MJ, Demuth K, Kehl R, Lindner A (2005) Sudden hearing loss as the leading symptom of an infarction of the left anterior inferior cerebellar artery. HNO 53:797–799
Asai Y, Umemura K, Kohno Y, Uematsu T, Nakashima M (1993) An animal model for hearing disturbance due to inner ear ischemia: photochemically induced thrombotic occlusion of the rata anterior inferior cerebellar artery. Eur Arch Otorhinolaryngol 250:292–296
Schweinfurth JM, Cacace AT (2000) Cochlear ischemia induced by circulating iron particles under magnetic control: an animal model for sudden hearing loss. Am J Otol 21:636–640
Kimura RS (1986) Animal models of inner ear vascular disturbances. Am J Otolaryngol 7:130–139
Nagahara K, Fisch U, Yagi N (1983) Perilymph oxygenation in sudden and progressive sensorineural hearing loss. Acta Otolaryngol 96:57–68
Lamm K, Lamm H, Arnold W (1998) Effect of hyperbaric oxygen therapy in comparison to conventional or placebo therapy or no treatment in idiopathic sudden hearing loss, acoustic trauma, noise-induced hearing loss and tinnitus: a literature survey. Adv Otorhinolaryngol 54:86–89
Lamm K, Lamm H, Arnold W (1998) Effect of isobaric oxygen versus hyperbaric oxygen on the normal and noise-damaged hypoxic and ischemic guinea pig inner ear. Adv Otorhinolaryngol 54:59–85
El Barbary A, Altschuler RA, Schacht J (1993) Glutathione S-transferases in organ of corti of the rat: enzymatic activity, subunit composition and immunohistochemical localization. Hear Res 71:80–90
Gregorevic P, Lynch GS, Williams DA (2001) Hyperbaric oxygen modulates antioxidant enzyme activity in rat skeletal muscles. Eur J Appl Physiol 86:24–27
Takahashi H, Kobayashi S (1998) New indications for hyperbaric oxygen therapy and its complication. Adv Otorhinolaryngol 54:1–13
Plafki C, Peters P, Almeling M, Welslau W, Busch R (2000) Complications and side effects of hyperbaric oxygen therapy. Aviat Space Environ Med 71:119–124
Fernau JL, Hirsch BE, Derkay C, Ramasastry S, Schaefer SE (1992) Hyperbaric oxygen therapy: effect on middle ear and eustachian tube function. Laryngogoscope 102:48–52
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Fujimura, T., Suzuki, H., Shiomori, T. et al. Hyperbaric oxygen and steroid therapy for idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 264, 861–866 (2007). https://doi.org/10.1007/s00405-007-0272-6
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DOI: https://doi.org/10.1007/s00405-007-0272-6