. 2025 Jan 18;11(2):e42025.

doi: 10.1016/j.heliyon.2025.e42025. eCollection 2025 Jan 30.

Hyperbaric oxygen therapy improves the effects of systemic steroid therapy for sudden sensorineural hearing loss

Yu-Ching Chen¹, Yu-Hsi Liu^{2

3}, Bor-Hwang Kang^{2

4

5

6}, Cai-Sin Yao^{7

8}, Yao-Shen Chen⁹, Wen-Chung Liu^{1

10

11

12}

Affiliations

¹ Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
² Department of Otorhinolaryngology, Head & Neck Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
³ Institute of Biomedical Science, National Sun Yat-sen University, No.70 Lien-hai Road, Kaohsiung, 804201, Taiwan, ROC.
⁴ Department of Pharmacy, Tajen University, No.20, Weixin Rd., Yanpu Township, Pingtung County, 907101, Taiwan, ROC.
⁵ School of Medicine, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC.
⁶ Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Neihu District, Taipei City, 114202, Taiwan, ROC.
⁷ Department of Medical Education and Research, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
⁸ Department of Business Management, National Sun Yat-sen University, No.70 Lien-hai Road, Kaohsiung, 804201, Taiwan, ROC.
⁹ Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
¹⁰ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St. Beitou Dist., Taipei City, 112304, Taiwan, ROC.
¹¹ School of Medicine, College of Medicine, National Sun Yat-sen University, No.70 Lien-hai Road, Kaohsiung, 804201, Taiwan, ROC.
¹² Institute for Translational Research in Biomedicine, Chang Gung Memorial Hospital, No.123, Dapi Road, Niaosong District, Kaohsiung City, 833401, Taiwan, ROC.

PMID: 39906861
PMCID: PMC11791220
DOI: 10.1016/j.heliyon.2025.e42025

Hyperbaric oxygen therapy improves the effects of systemic steroid therapy for sudden sensorineural hearing loss

Yu-Ching Chen et al. Heliyon. 2025.

. 2025 Jan 18;11(2):e42025.

doi: 10.1016/j.heliyon.2025.e42025. eCollection 2025 Jan 30.

Authors

Yu-Ching Chen¹, Yu-Hsi Liu^{2

3}, Bor-Hwang Kang^{2

4

5

6}, Cai-Sin Yao^{7

8}, Yao-Shen Chen⁹, Wen-Chung Liu^{1

10

11

12}

Affiliations

¹ Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
² Department of Otorhinolaryngology, Head & Neck Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
³ Institute of Biomedical Science, National Sun Yat-sen University, No.70 Lien-hai Road, Kaohsiung, 804201, Taiwan, ROC.
⁴ Department of Pharmacy, Tajen University, No.20, Weixin Rd., Yanpu Township, Pingtung County, 907101, Taiwan, ROC.
⁵ School of Medicine, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490, Taiwan, ROC.
⁶ Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Neihu District, Taipei City, 114202, Taiwan, ROC.
⁷ Department of Medical Education and Research, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
⁸ Department of Business Management, National Sun Yat-sen University, No.70 Lien-hai Road, Kaohsiung, 804201, Taiwan, ROC.
⁹ Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 813414, Taiwan, ROC.
¹⁰ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St. Beitou Dist., Taipei City, 112304, Taiwan, ROC.
¹¹ School of Medicine, College of Medicine, National Sun Yat-sen University, No.70 Lien-hai Road, Kaohsiung, 804201, Taiwan, ROC.
¹² Institute for Translational Research in Biomedicine, Chang Gung Memorial Hospital, No.123, Dapi Road, Niaosong District, Kaohsiung City, 833401, Taiwan, ROC.

PMID: 39906861
PMCID: PMC11791220
DOI: 10.1016/j.heliyon.2025.e42025

Abstract

Objectives: This study aimed to investigate the therapeutic efficacy of combined hyperbaric oxygen therapy (HBOT) and steroid therapy in treating sudden sensorineural hearing loss (SSNHL).

Design: This retrospective analysis included 505 patients diagnosed with SSNHL from August 2017 to July 2022. The patients received either a systemic steroid (SS) alone or SS with HBOT. Hearing improvement was evaluated with pure-tone audiometry (PTA). Among the participants, 102 received SS + HBOT, whereas 403 were treated with SS alone.

Results: The SS + HBOT group demonstrated significantly better improvement in the PTA threshold averaged across four low frequencies (PTA₄) scores (22.7 ± 23.5 vs. 16.2 ± 21.4, P = 0.007) and higher response rates (≥15 dB improvement) and significant response (≥25 dB improvement) (61.8 % vs. 44.4 %, P = 0.002; and 43.1 % vs. 22.6 %, P < 0.001, respectively) than the SS-alone group. HBOT is particularly effective in patients with hearing loss at lower frequencies. Patients treated with HBOT were 2.50 times more likely to achieve substantial hearing improvement. Patients receiving three HBOT sessions or initiating treatment within 11 days of diagnosis demonstrated optimal outcomes. Greater improvements were observed in patients with initial hearing loss of >50 dB and younger individuals.

Conclusions: HBOT improves the effectiveness of SS treatment in SSNHL, with notable benefits for younger patients and those with an initial hearing loss of >50 dB. HBOT exhibited more pronounced effects at lower frequencies. Initiating HBOT within 11 days of the SSNHL diagnosis is recommended, and a regimen of five sessions is indicated for optimal results.

Keywords: Hyperbaric oxygen therapy; Steroid; Sudden sensorineural hearing loss; Treatment.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

**Fig. 1**
Flow chart of the study population.

**Fig. 2**
Distribution of patients' severity before and after treatment. Notes: ∗ P-value <0.05; ∗∗ P-value <0.01.

See this image and copyright information in PMC

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Hyperbaric oxygen therapy improves the effects of systemic steroid therapy for sudden sensorineural hearing loss

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Hyperbaric oxygen therapy improves the effects of systemic steroid therapy for sudden sensorineural hearing loss

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