Idiopathic Sudden Sensorineural Hearing Loss: Is Hyperbaric Oxygen Treatment the Sooner and Longer, the Better?

(1) Background: We aimed to evaluate hearing benefits from hyperbaric oxygen (HBO) therapy in patients with Idiopathic Sudden Sensorineural Hearing Loss (ISSHL). (2) Methods: We performed a retrospective analysis of chart reviews on patients with ISSHL between Jan 2016 and Dec 2021. All patients were referred to receive HBO therapy by the department of Ear, Nose and Throat (ENT). Hearing gain was assessed based on pure-tone audiometry (PTA). Data were analyzed for 102 patients after 1 to 5 therapy sessions, and for 46 patients after 6 to 10 therapy sessions. (3) Results: After 1−5 HBO sessions, patients (N = 102) showed an improvement in 45 (44.1%) of the patients (p < 0.000). Also, improvements were found with patients showing different grades of ISSHL: 11 (26.8%) with slight-moderate, 11 (40.7%) with severe, and 23 (67.6%) with profound ISSHL. Significant treatment effects were found at different affected frequencies, especially the low frequency range. After 6−10 HBO sessions, patients (N = 46) showed similar treatment effects as after 1−5 HBO sessions, but no additional improvement. Moreover, patients who received HBO treatment within 12 days showed improvement effects 6.484 times greater (p < 0.000) compared with those who received treatment after 13 days. (4) Conclusions: The improvement of HBO therapy on ISSHL was significant after 1−5 sessions, with larger improvements for those suffering more serious symptoms. Further adding more HBO treatment sessions to 6−10, no further improvement was found. Patients starting HBO therapy within 12 days of ISSHL showed 6.484 times greater improvements compared with those starting HBO therapy later.

Adjunctive hyperbaric oxygen treatment for idiopathic sudden sensorineural hearing loss.

INTRODUCTION: This study aims to evaluate the hearing gain efficacy from adjunctive hyperbaric oxygen (HBO2) treatment in patients with idiopathic sudden sensorineural hearing loss (ISSHL). MATERIALS AND METHODS: A retrospective analysis of chart reviews was performed on patients with ISSHL between January 2013 through December 2015. All patients were referred to us from our ENT Department for adjunctive hyperbaric oxygen treatment. The results were assessed through pure-tone audiometry (PTA) data change (hearing gain), both before and after HBO2) treatment. Age, gender, affected ear side, HBO2) treatment sessions, both before and after HBO2 treatment PTA were all recorded. RESULTS: Ninety-three (93) patients with ISSHL were included in the study. The average hearing gain in this study was 17.9 dB (p=0.001), where a total of 46 (49.46%) patients showed an improvement (hearing gain≥dB) in response to HBO2 treatment (p=0.002). Patients with the poorest initial severity of hearing loss who displayed a greater degree of hearing improvement after HBO2 treatment were male and in the 40- to 59-year-old age group. CONCLUSION: This study found that adjunctive hyperbaric oxygen treatment was efficacious for patients with idiopathic sudden sensorineural hearing loss. The total average hearing gain was recorded to be 17.9 dB.

Effect of human autologous serum and fetal bovine serum on human corneal epithelial cell viability, migration and proliferation in vitro.

AIM: To analyze the concentration-dependent effects of autologous serum (AS) and fetal bovine serum (FBS) on human corneal epithelial cell (HCEC) viability, migration and proliferation. METHODS: AS was prepared from 13 patients with non-healing epithelial defects Dulbecco's modified eagle medium/Ham's F12 (DMEM/F12) with 5% FBS, 0.5% dimethyl sulphoxide (DMSO), 10 ng/mL human epidermal growth factor, 1% insulin-transferrin-selenium, then were incubated in serum media: DMEM/F12 supplemented by 5%, 10%, 15% or 30% AS or FBS. HCEC viability was analyzed using cell proliferation kit XTT, migration using a wound healing assay, proliferation by the cell proliferation enzyme-linked immunosorbent assay (ELISA) BrdU kit. Statistical analysis was performed using the generalized linear model, the values at 30% AS or 30% FBS were used as the baselines. RESULTS: HCEC viability was the highest at 30% AS or 15% FBS and the lowest at 10% AS or 30% FBS application. HCEC migration was the quickest through 30% AS or 30% FBS and the slowest through 5% AS or 5% FBS concentrations. Proliferation was the most increased through 15% AS or 5% FBS and the least increased through 30% AS or 30% FBS concentrations. HCEC viability at 10% and 15% AS was significantly worse (P=0.001, P=0.023) compared to baseline and significantly better at 15% FBS (P=0.003) concentrations. HCEC migration was significantly worse (P≤0.007) and HCEC proliferation significantly better (P<0.001) in all concentration groups compared to baseline. CONCLUSION: For the best viability of HCEC 30% AS or 15% FBS, for HCEC migration 30% AS or 30% FBS, for proliferation 15% AS or 5% FBS should be used. Therefore, we suggest the use of 30% AS in clinical practice.

Cordyceps sobolifera extract ameliorates lipopolysaccharide-induced renal dysfunction in the rat.

Cordyceps Sobolifera (CS), an economic traditional Chinese herb, may ameliorate nephrotoxicity-induced renal dysfunction in the rat via antioxidant, anti-apoptosis, and anti-autophagy mechanisms. We investigated the water extract of fermented whole broth of CS on lipopolysaccharide (LPS)-induced renal cell injury in vitro and in vivo. CS effect on LPS-induced epithelial Lilly pork kidney (PK1) and Madin-Darby canine kidney epithelial (MDCK) cell death was detected with MTT assay. Two-month treatment of CS effects on renal blood flow (RBF), glomerular filtration rate (GFR), plasma blood urea nitrogen, creatinine level and leukocytes (WBC) count were determined in the LPS-treated rats. We further examined the effects of CS supplement on renal tubular oxidative stress, endoplasmic reticulum stress, apoptosis and autophagy by Western blot analysis. LPS dose-dependently induced PK1 and MDCK cell death, which can be ameliorated by CS treatment. LPS significantly decreased RBF and GFR and increased blood leukocyte counts, plasma blood urea nitrogen and creatinine level in the rat after 24 hours of injury. LPS enhanced renal tubular ER stress, autophagy and apoptosis via by increase protein expressions of GRP78, caspase 12, Beclin-1 and Bax/Bcl-2 ratio. These findings are associated with the significant staining in renal proximal and distal tubular ED-1, GRP78, Beclin-1 autophagy, and TUNEL apoptosis in the LPS-treated kidneys. Two months of CS supplement significantly improved RBF, GFR and WBC values and reduced ED-1, GRP78, Beclin-1 autophagy and TUNEL apoptosis in the LPS-treated kidneys. Long-term CS treatment reduced LPS-induced stress responses and tissue damage possibly via blocking LPS-triggered signaling pathways.