OBJECTIVE:To measure the effect of hyperbaric oxygen (HBO) therapy as salvage therapy after the failure of steroid therapy for sudden sensorineural hearing loss (SSNHL). MATERIALS and METHODS:Ninety-three patients with SSNHL were unsuccessfully treated with systemic steroid therapy. Following steroid therapy, 43 patients received additional HBO therapy while 50 did not. Hearing levels at 0.25, 0.5, 1, 2, 4, and 8 kHz before and after therapy were measured. RESULTS:A significant difference in hearing thresholds after HBO therapy was found at all frequencies in patients with a hearing loss of >61 dB. The group of patients with a hearing threshold of ≤60 dB had a significant improvement only at 250 and 500 Hz, while group of patients without additional therapy control group showed no hearing improvement. CONCLUSION:Hyperbaric oxygen therapy therapy as salvage therapy for SSNHL showed some benefits in hearing improvement. Better results could be expected in patients with severe hearing loss, while in patients with mild-or-moderate hearing loss, recovery should be expected only at low frequencies.

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This report presents a rare case of a fistula between the temporomandibular joint and the external auditory meatus, associated with Huschke's foramen. Such a defect can be quite difficult to detect. It should be suspected in cases of chronic otorrhoea when neither middle nor external ear disease is apparent. Surgery is usually successful, and is advised in cases with repeated complications.

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Purpose: This paper investigates the possible connections between the level of chronic stress and success of steroid therapy in patients with sudden sensorineural hearing loss (SSNHL). Method: A single-center retrospective longitudinal cohort study on 55 patients in a tertiary referral otology center. Patients diagnosed with SSNHL between 2014 and 2017 were asked to complete a Measure of Perceived Stress (MPS) questionnaire. Inclusion criteria were patients >18 years of age, SSNHL diagnosed within 4 previous weeks, completed steroid treatment, and complete documentation. Results: There were 30 patients (55%) that showed significant improval in their pure tone audiogram (PTA) hearing threshold average (≥15 dB) after steroid treatment. Two-step cluster analysis identified three clusters based on average PTA hearing threshold recovery and average MPS scores. The difference between pre-treatment and post-treatment hearing levels was significantly higher in the cluster with moderate stress compared to clusters with mild and high stress levels (Kruskal-Wallis test, Friedman test, P<0.001). There were no significant differences in average PTA hearing threshold recovery after steroid therapy between groups of patients with mild and severe stress. Conclusions: Patients with moderate stress levels show significantly better results after steroid treatment for SSNHL than patients with low or high stress levels.