Why Protocol Matters In HBOT For SSNHL
Sudden sensorineural hearing loss, often abbreviated as SSNHL, is typically treated with corticosteroids as a first line therapy. Hyperbaric oxygen therapy is increasingly being used as an additional treatment, but questions remain about the best pressure and duration settings. This study focused on finding an optimized hyperbaric oxygen therapy protocol for sudden sensorineural hearing loss when HBOT is combined with systemic and intratympanic steroids.
Inside The Study: Comparing Three HBOT Settings
A total of 112 patients with SSNHL were enrolled in a prospective clinical study. All patients received three components of treatment:
- Systemic steroid therapy
- Intratympanic steroid therapy
- Hyperbaric oxygen therapy over 10 total sessions
Patients were divided into three HBOT protocol groups based on chamber pressure and session duration:
- Group 1: 2.5 atmospheres absolute for 1 hour
- Group 2: 2.5 atmospheres absolute for 2 hours
- Group 3: 1.5 atmospheres absolute for 1 hour
Researchers then compared pure tone average, word discrimination score and overall hearing gain after treatment, with follow up at three months.
Key Findings: Pressure Versus Duration
Of the original group, 105 patients completed the three month follow up. The analysis showed significant differences among the three HBOT protocols. In particular:
- Groups 1 and 2, both using 2.5 atmospheres, had higher word discrimination scores and greater mean hearing gain than group 3
- Group 3, treated at 1.5 atmospheres, had noticeably lower functional improvement
- The proportion of patients who experienced hearing recovery was higher in group 1 and group 2, at about 58 percent, compared with about 31 percent in group 3
- There was no meaningful difference in outcomes between group 1 and group 2, suggesting that extending the session from 1 hour to 2 hours at 2.5 atmospheres did not add clear benefit
Practical Takeaways For HBOT Use In SSNHL
When hyperbaric oxygen therapy was added to steroid based initial treatment for SSNHL, a higher pressure setting of 2.5 atmospheres produced better hearing outcomes than a lower pressure of 1.5 atmospheres. Increasing the session duration from 1 hour to 2 hours at the higher pressure did not significantly change results.
Based on these findings, the authors suggest that HBOT for sudden sensorineural hearing loss can reasonably be performed at 2.5 atmospheres absolute for 1 hour per session, for a total of 10 sessions, when used as part of combined therapy. As always, individual treatment decisions should be guided by a hearing specialist and tailored to each patient’s clinical situation.
Check out the PubMed article here: https://pubmed.ncbi.nlm.nih.gov/35548932/
