The Role of Hyperbaric Oxygen as Salvage Therapy for Sudden Sensorineural Hearing Loss

Objective: We sought to evaluate hearing outcomes after salvage therapy with hyperbaric oxygen (HBO2) for the treatment of sudden sensorineural hearing loss (SSNHL). Study Design: Matched control retrospective case series. Setting: Tertiary neurotology referral center. Patients: Thirty-six patients (>18 years) diagnosed with SSNHL. Intervention: Patients received initial therapy with oral and/or intratympanic (IT) steroids with an incomplete response. Eighteen patients underwent salvage therapy with IT steroids and HBO2 (group 1). Eighteen matched controls underwent salvage therapy with IT steroids alone (group 2). Main outcome measures: The main outcome measure was improvement in pure tone average (PTA) and word recognition score (WRS). Complications as a result of therapy were also monitored. Results: There were no significant differences in age, gender, or hearing between the 2 groups (P > .05). There was no significant difference in mean post-treatment PTA between group 1 (60.3 dB) and group 2 (53.2 dB). There were no significant difference in mean post-treatment WRS between group 1 (42%) and group 2 (51%). Serviceable hearing was defined as a minimum WRS of 50%. Thirty-three percent in group 1 and 42% in group 2 went from nonserviceable hearing to serviceable hearing (P > .05). PTA and WRS change scores were not significantly affected by age, gender, form of initial treatment, or pre-treatment PTA and WRS. Conclusion: The present study demonstrated no significant difference in hearing outcomes between patients receiving salvage therapy with HBO2 and IT steroids compared to patients receiving IT steroids alone. Larger, prospective randomized trials are needed to better define the role of HBO2 as salvage therapy for SSNHL.