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Randomized Controlled Trial
. 2022 Oct 10;58(10):1421.
doi: 10.3390/medicina58101421.

Combination of Hyperbaric Oxygen Therapy and Oral Steroids for the Treatment of Sudden Sensorineural Hearing Loss: Early or Late?

Matteo Cavaliere  1 , Pietro De Luca  1 , Alfonso Scarpa  1 , Adriano Maciej Strzalkowski  1 , Massimo Ralli  2 , Matteo Calvanese  1 , Luisa Savignano  1 , Pasquale Viola  3 , Claudia Cassandro  4 , Giuseppe Chiarella  3 , Arianna Di Stadio  5
Affiliations
Randomized Controlled Trial

Combination of Hyperbaric Oxygen Therapy and Oral Steroids for the Treatment of Sudden Sensorineural Hearing Loss: Early or Late?

Matteo Cavaliere et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Several treatments are available for sudden sensorineural hearing loss (SSNHL), but no studies have compared the different treatments based on the delay from the onset of the disease. Our study aims to compare the effect of hyperbaric oxygen therapy (HBOT), oral steroids (OS) and combination of both therapies (HBOT + OS) for treating SSNHL. Materials and Methods: This randomized study analyzed 171 patients with SSNHL. Patients were evaluated by pure tone audiometry test (PTA) at baseline (T0) and 20 days after treatment (T1). Three groups were available HBOT-A-, OS-B- and HBOT + OS-C-. After baseline PTA, patients were randomly assigned to each group. Statistical analysis was performed by one-way ANOVA and Chi-square. Results: Patients in the HBOT + OS and HBOT groups improved their auditory function (p < 0.05). HBOT was the best choice for treatment when started by 7 days from SSNHL onset, while HBOT + OS in case of late treatment. Profound SNHL recovered equally by HBOT and HBOT + OS (p < 0.05). Upsloping SNHL obtained better auditory results by HBOT compared to HBOT + OS (p < 0.05). Downsloping and flat SSNHL had the most improvement with HBOT + OS compared to HBOT only (p < 0.05). Conclusions: Combination of HBOT and OS is a valid treatment for SSNHL both in case of early and late treatment. Combination of HBOT and OS was the choice with the best results in case of treatment started >14 days from symptom onset.

Keywords: HBOT; hyperbaric oxygen therapy; idiopathic sudden hearing loss; steroid therapy; sudden deafness.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of hearing recovery among the groups.
Figure 2
Figure 2
The graphs show the prevalence of recovering comparing the groups. Profound SNHL recovers same comparing HBOT alone or combined with OS; the Upsloping SNHL recovers better by HBOT alone than HBOT + OS; finally, Downsloping SNHL recovers better using HBOT + OS compared to HBOT only. In all cases, OS as single treatment is not sufficient to recover.
Figure 3
Figure 3
The graph shows the differences in the recovery at different time points among the three groups. HBOT and HBOT + OS allow to improve the hearing functions even after more than 15 days from the hearing loss onset.
See this image and copyright information in PMC

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