Over 66,000 NEW cases of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) present every year in the United States. Hearing loss defined as a loss of greater than 30 decibels over (3) three contiguous frequencies over 72 hours. In many cases, it is accompanied by ringing in the ears or tinnitus, a feeling of fullness in the ear or a sudden pop, or dizziness. It usually affects one ear and should be treated as a medical emergency since permanent hearing loss is a real possibility. It is thought that there is a decrease of oxygen to the hairs cells within the cochlea and that there is an increase in inflammation resulting in deafness. The Ear, Nose, and Throat (ENT) literature says that between 1/3 to 2/3 of the patient will have a spontaneous recovery, but many of these only regained 50% of their previous hearing. Prompt and aggressive treatment is appropriate to salvage as much hearing as possible.
Hyperbaric Oxygen for Sudden Hearing Loss
Disruptions of blood flow to the cochlea (hypoxia) and the hair cells, in conjunction with an inflammatory process in the cochlea, can lead to sudden hearing loss. Hyperbaric oxygen reverses both the hypoxia and the inflammatory response. Standard treatment usually involves steroids, either intravenously, orally, by intratympanic injections, or in combination. Adding hyperbaric oxygen therapy has been shown to improve outcomes. A recent study showed that patients who had combination therapy of steroids and hyperbaric oxygen had a 61% higher chance of achieving complete hearing recovery than those that just got steroids.
Multiple studies have affirmed that starting hyperbaric oxygen therapy early in the course of this disease confers better benefits. Both the Cochrane Review and the clinical practice guidelines of the American Academy of Otolaryngology-Head and Neck Surgery include hyperbaric oxygen as a reasonable addition to steroid therapy.