Sudden hearing loss is a common ENT emergency that occurs abruptly and, if not treated promptly, may lead to permanent hearing loss. In recent years, hyperbaric oxygen therapy (HBOT), a non-invasive treatment, has been widely used as an adjunctive therapy for sudden hearing loss. But is hyperbaric oxygen therapy truly effective? Who is it suitable for? This article will provide you with a detailed explanation.
Sudden sensorineural hearing loss (SSNHL) is defined as a hearing loss of at least 30 decibels over at least three consecutive frequencies, occurring within 3 days. Most cases are considered idiopathic, with patients typically first noticing the symptoms upon waking. They often describe a sensation of ear fullness or blockage.
Possible causes of sudden hearing loss include vascular obstruction, viral infections, labyrinthine membrane rupture, autoimmune disorders, trauma, toxins, cochlear membrane damage, demyelinating diseases, stroke, and vestibular schwannoma. In addition to feeling fullness or blockage in the ear, patients may also experience tinnitus (common), dizziness, or vertigo.
In the United States, approximately 4,000 new cases are reported annually. However, because many patients do not seek medical attention, it is difficult to determine the exact rate of spontaneous recovery. Reported spontaneous recovery rates range from as low as 25% to as high as 65%.
Hyperbaric oxygen therapy (HBOT) involves breathing high-concentration pure oxygen in a sealed, high-pressure chamber. This process increases the oxygen level in the blood, thereby achieving several therapeutic effects:
Enhances oxygen supply to the inner ear, promoting the repair of hair cells.
Improves microcirculation, alleviating cochlear ischemia (lack of blood flow).
Reduces inflammation and edema (swelling) in the inner ear tissues.
Produces a synergistic effect when combined with treatments such as corticosteroids and vasodilators.
An increasing body of evidence suggests that combining corticosteroids with hyperbaric oxygen therapy (HBOT) can significantly improve hearing in patients with acute idiopathic sudden sensorineural hearing loss (ISSHL). However, this approach appears ineffective for patients with chronic ISSHL. The underlying theory is that HBOT enhances oxygen delivery to the inner ear, promotes healing, and reduces inflammation, thereby helping many patients recover their hearing.
HBOT significantly increases the partial pressure of oxygen in the blood, up to 10–15 times that at normal atmospheric pressure. This extended oxygen diffusion improves oxygen delivery directly to ischemic tissues in the cochlea, alleviating damage caused by oxygen deprivation in hair cells. Additionally, HBOT dilates the vertebrobasilar arteries, enhances inner ear blood flow, reduces blood viscosity (by approximately 20%), and decreases platelet aggregation, all contributing to improved microcirculation.
HBOT lowers levels of pro-inflammatory cytokines and activates antioxidant enzymes like superoxide dismutase (SOD). This dual action helps to reduce inflammation and protect cochlear cells from damage caused by free radicals.
By boosting ATP synthesis in cochlear hair cells, HBOT accelerates the repair of damaged nerve cells. Some studies have reported hearing recovery rates of over 80% in patients who receive timely treatment.
Studies have shown that starting hyperbaric oxygen therapy within 72 hours of the onset of the disease dramatically increases the rate of hearing recovery. The efficacy is even more pronounced when combined with drug therapy such as glucocorticoids.
Hyperbaric Oxygen Therapy Features:
Non-invasive and less painful;
Standardized treatment process: 60-90 minutes once a day;
Cycles are usually 10-20 times.;
Assessment of effect: comparison of changes before and after treatment by audiogram.
Hyperbaric oxygen therapy helps to improve the hypoxic state of the inner ear and promotes hearing recovery in patients with sudden neurological hearing loss by increasing the oxygen tension of the external lymphatic fluid. Its efficacy is influenced by factors such as the degree of labyrinthine artery patency and the efficiency of oxygen delivery. Several prospective randomized controlled studies have demonstrated the therapeutic advantages of hyperbaric oxygen therapy over placebo.
Heather M. Murphy-Lavoie; Mesut Mutluoglu's paper Hyperbaric Treatment of Sensorineural Hearing Loss mentioned:
The American Academy of Otolaryngology recommends that patients be treated with a combination of systemic or tympanic injections of steroids with hyperbaric oxygen within 14 days of symptom onset for optimal results. The recommended steroid dose is 1 mg/kg/day and is tapered over 2 to 3 weeks. Hyperbaric oxygen intervention should especially be considered for patients with moderate to severe hearing loss (>40 dB).
Even if initial steroid therapy is ineffective, patients may still benefit from receiving hyperbaric oxygen combined with tympanic steroid injection within 10 weeks of onset. The official guidelines do not recommend the routine use of antivirals, thrombolytics, vasodilators, or antioxidants.
A comprehensive assessment of the patient's condition using audiogram, MRI of the brain, and autoimmune and vascular evaluation is required before treatment. It is recommended to review the audiogram periodically during (after 10 sessions), after (after 20 sessions), and within 6 months of treatment. At the same time, the doctor should fully explain to the patient that the condition may carry the risk of incomplete hearing recovery and introduce the benefits and options of assistive technologies such as amplification and hearing aids.
A systematic review and data analysis included three prospective randomized controlled trials (RCTs) of patients with sudden sensorineural hearing loss aged ≥18 years who met the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) diagnostic criteria for SSNHL. A total of 88 individuals in the intervention group received hyperbaric oxygen therapy, and 62 individuals in the control group received steroids or a placebo.
Results showed that hyperbaric oxygen therapy was significantly better than the control group in terms of hearing recovery, including:
Difference in mean hearing gain: 10.3 dB (95% CI: 6.5-14.1 dB)
Hearing recovery advantage ratio (OR): 4.3 (95% CI: 1.6-11.7)
The findings support that hyperbaric oxygen, as an effective complement to pharmacologic treatments such as steroids, significantly improves hearing outcomes in patients with SSNHL.
As the industry's leading manufacturer of hyperbaric oxygen chambers, Oxyair offers a range of professional oxygen chamber equipment suitable for deafness rehabilitation in scenarios such as ENT departments, hearing rehabilitation centers, and community-based rehabilitation facilities:
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