RESUMEN
We analyzed 356 patients with idiopathic sudden sensorineural hearing loss treated with hyperbaric oxygen therapy and systemic steroids (n = 161), systemic steroids alone (n = 160), or intratympanic and systemic steroids (n = 35). The main outcome measure was the hearing recovery rate. The effect of other variables, including the initial averaged 5-frequency hearing level, patient age, interval between the onset of symptoms and treatment, presence of vertigo as a complication, presence of diabetes mellitus, smoking history, and presence of hypertension, on the hearing recovery rate was also evaluated. The overall hearing recovery rate was significantly higher for the patients treated with hyperbaric oxygen therapy and systemic steroids than for those treated with systemic steroids alone (p < 0.001) or systemic and intratympanic steroids (p < 0.001). The presence of vertigo negatively affected hearing recovery. Our findings suggest that hyperbaric oxygen therapy confers a significant additional therapeutic benefit when used in combination with steroid therapy for idiopathic sudden sensorineural hearing loss.
Asunto(s)
Glucocorticoides/uso terapéutico , Pérdida Auditiva Sensorineural/terapia , Pérdida Auditiva Súbita/terapia , Oxigenoterapia Hiperbárica/métodos , Administración Oral , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Terapia Combinada , Comorbilidad , Diabetes Mellitus/epidemiología , Femenino , Audición , Pérdida Auditiva Sensorineural/complicaciones , Pérdida Auditiva Sensorineural/epidemiología , Pérdida Auditiva Sensorineural/fisiopatología , Pérdida Auditiva Súbita/complicaciones , Pérdida Auditiva Súbita/epidemiología , Pérdida Auditiva Súbita/fisiopatología , Pruebas Auditivas , Humanos , Hipertensión/epidemiología , Inyección Intratimpánica , Masculino , Persona de Mediana Edad , Pronóstico , Recuperación de la Función , Estudios Retrospectivos , Fumar/epidemiología , Resultado del Tratamiento , Vértigo/etiología , Vértigo/fisiopatología , Adulto JovenRESUMEN
We evaluated the outcomes of and prognostic factors for idiopathic sudden sensorineural hearing loss (ISSNHL) treated with adjuvant hyperbaric oxygen therapy (HBOT). A retrospective review of clinical data was performed for 167 patients with ISSNHL who failed to respond to systemic steroids and were treated by adjuvant HBOT at Shizuoka Saiseikai General Hospital. We analysed the clinical outcomes, the averaged 5-frequency hearing level after systemic steroids, patient age, the interval between post-steroids and pre-HBOT, vertigo as a complication, the presence of diabetes mellitus, smoking history, and hypertension. Overall, after HBOT, complete recovery occurred in 16 (9.6%) of the patients, with definite improvement in 16 (9.6%) and slight improvement in 45 (26.9%). The overall rate of hearing improvement was higher in the study group (77/167 cases, 46.1%) than in the control group (52/160 cases, 32.5%; p = 0.021). If performed appropriately, HBOT should be able to improve hearing in many cases unresponsive to initial therapy.