Sudden Hearing Loss: More Common than We Thought

Losing one of your senses needs to be addressed urgently, because once lost, it might not come back. The sudden loss of hearing in one ear should be treated as a medical emergency.

Over 66,000 NEW cases of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) present every year in the United States.[1] (https://www.ncbi.nlm.nih.gov/pubmed/24232060).  This is defined as a loss of greater than 30 decibels over 3 contiguous frequencies over a 72-hour period.   The ENT literature says that between 1/3 to 2/3 of patients will have spontaneous recovery, but many of these only regained 50% of their previous hearing.  Prompt and aggressive treatment is appropriate to salvage as much hearing as possible.

Treatment usually involves steroids, either intravenous, oral, or intratympanic injections, or a combination of these. Adding hyperbaric oxygen therapy has been shown to improve outcomes. A recent study showed that patients that had combination therapy of steroids and hyperbaric oxygen had a 61% higher chance of achieving complete hearing recovery than those that just got steroids. [2]https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2704029

Why would HBOT help? One of the causes for sudden hearing loss may be due to a lack of oxygen to the cochlea, the part of the inner ear responsible for hearing. Hyperbaric oxygen is designed to increase the amount of oxygen that is dissolved in the plasma and increases the available oxygen to this area.

Multiple studies have affirmed that starting hyperbaric oxygen therapy early in the course of this disease confers better benefits. Both the Cochrane Review[3] https://www.cochrane.org/CD004739/ENT_hyperbaric-oxygen-for-sudden-hearing-loss-and-tinnitus-ringing-in-the-ears-of-unknown-cause and the clinical practice guidelines [4]of the American academy of Otolaryngology-head and Neck Surgery https://journals.sagepub.com/doi/abs/10.1177/0194599812436449 include hyperbaric oxygen as a reasonable addition to steroid therapy.

Almost all studies that have researched the combination of hyperbaric oxygen and steroids in sudden hearing loss recommend early implementation of hyperbaric oxygen therapy.

Many insurance carriers are starting to cover this therapeutic option, but even if the plan does not cover it, you should consider starting hyperbaric oxygen therapy.  Most patients started to see clinical benefit within 2 weeks or 10 treatments, although some needed up to 20 to achieve the best outcomes.

If you have sudden hearing loss, see your ear nose and throat physician immediately, and then consider adding hyperbaric oxygen to the treatment protocol.

Call us to schedule an urgent consultation.

1. Alexander, Thomas H., and Jeffrey P. Harris. "Incidence of sudden sensorineural hearing loss." Otology & Neurotology 34.9 (2013): 1586-1589.

2. Rhee T, Hwang D, Lee J, Park J, Lee JM. Addition of Hyperbaric Oxygen Therapy vs Medical Therapy Alone for Idiopathic Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1153–1161. doi:10.1001/jamaoto.2018.2133

3. Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database of Systematic Reviews 2012, Issue 10

4. Stachler, Robert J., et al. "Clinical practice guideline: sudden hearing loss." Otolaryngology—Head and Neck Surgery 146.3_suppl (2012): S1-S35.