What is the role of hyperbaric oxygen therapy (HBOT) in the treatment of sudden sensorineural hearing loss (SSHL)?

Updated: Nov 16, 2020
  • Author: Emi Latham, MD, FACEP, FAAEM, UHM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Sudden sensorineural hearing loss (SSHL) is a relatively rare cause of sensorineural hearing loss of at least 30 dB in three contiguous frequencies over three days. [111] An associated common complaint in 90% of patients is tinnitus, usually unilateral. [112] Patients can also present with a sensation of fullness or a blocked ear [113] or vertigo. [114]

SSHL has many causes, but idiopathic SSHL still predominates. Numerous etiologies have been proposed with about as many treatments. SSHL is thought to be related to inner ear hypoxia because the cochlea requires a high O2 supply. [115] HBOT increases the partial pressure of oxygen (pO2) in the inner ear. A Cochrane Review concluded a significant mean improvement in patients treated with HBOT. [116]

Candidates for HBOT demonstrate significant SSHL within 14 days of onset. The patient should undergo evaluation that includes audiology and imaging studies. If no contraindications are noted, oral steroids are also recommended. HBOT should ensue at 1.5-2.5 ATA for 90 minutes daily for 15-20 treatments. [117]

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