Prognostic factors for hearing outcomes in patients that undergo adjuvant hyperbaric oxygen therapy for sudden sensorineural hearing loss

Abstract

Introduction:The aim of this study is to explore the potential factors in hearing outcomes and verify the role of oxidant-antioxidant equilibrium on the prognosis of sudden sensorineural hearing loss (SSNHL) treated with hyperbaric oxygen therapy (HBOT).Methods: Ninety-two patients who were diagnosed with SSNHL between January 2018 and December 2019 in our hearing clinic center were included in this study. All patients were treated with intravenous dexamethasone, and 72 cases were treated with additional HBOT for 10 consecutive days. Peripheral blood was collected prior to any treatment to determine the blood cell count and hemoglobin (HGB), hematocrit (HCT), and superoxide dismutase (SOD) levels. Pure tone audiometry was measured before and after treatment. Complete and overall recovery rate was evaluated. Multivariate logistic analysis was used to identify prognostic factors.Results: The rate of overall recovery was significantly higher in the patient with combined therapy compared to patients treated with steroids only (51.4% vs 25.0%, p = .036). The levels of HGB, HCT, and SOD were much higher in the patients with better hearing outcomes (p = .027, .033, and .011, respectively). Multivariate logistic analysis demonstrated that patients with higher initial hearing thresholds, or hearing loss at overall frequency, were more prone to have poor hearing gains after HBOT. Conclusion:HBOT is effective as an early adjuvant therapy for SSNHL. Hearing loss at low frequency, low initial hearing thresholds, as well as high HBG, HCT, and SOD levels are positive prognostic factors for SSNHL patients treated with HBOT.

Hyperbaric Oxygen Therapy Promotes Hearing Gain with Increases in Serum IGF-1 and HSP70 in Patients with Idiopathic Sudden Sensorineural Hearing Loss

“…We showed that combining HBOT and medical therapy improved recovery (80.0% versus 57.1%) and hearing gain (25.1 ± 11.9 dB versus 13.3 ± 6.8 dB), compared to medical therapy alone. Consistent with our findings, several systematic reviews have shown that adding HBOT to steroid therapies can benefit patients with severe to profound ISSHL [ 4 , 19 ].…”

“…It a ects approximately 5−27 per 100,000 people annually, but its incidence has been increasing over the past decades [1][2][3]. Although its pathogenesis is incompletely understood, the most common triggers involve viral infections, vascular disorders, and autoimmune factors [1,4].…”

“…Increased oxygen delivery to the inner ear may aid hearing recovery due to the high oxygen demands and relatively limited vascular supply of the cochlea [ 4 ]. Hyperbaric oxygen therapy (HBOT) is a therapeutic approach in which the patient breathes 100% oxygen while being exposed to an ambient pressure of >1 atmosphere absolute [ 14 ].…”

Diagnostic and predictive values of serum metabolic profiles in sudden sensorineural hearing loss patients

“…Currently, the pathogenic causes of SSNHL are still debated, and several possible etiologies have been proposed, including viral infection, vascular disorders, trauma and autoimmune diseases ( Shen et al, 2021 ; Wu et al, 2022a ; Feng et al, 2022 ). As a medical emergence, detailed examination to determine possible causes and early treatment onset is extremely important to improve hearing prognosis in SSNHL patients ( Jiang et al, 2021 ; Huo et al, 2022 ). Although numerous studies were performed to determine the diagnostic and prognostic biomarkers in SSNHL, no reliable indicator was available in practice ( Huo et al, 2022 ; Park et al, 2022 ).…”

“…As a medical emergence, detailed examination to determine possible causes and early treatment onset is extremely important to improve hearing prognosis in SSNHL patients ( Jiang et al, 2021 ; Huo et al, 2022 ). Although numerous studies were performed to determine the diagnostic and prognostic biomarkers in SSNHL, no reliable indicator was available in practice ( Huo et al, 2022 ; Park et al, 2022 ). Recently, an increasing number of evidence showed that metabolic diseases were independent risk factors for the occurrence of SSNHL, and pathoglycemia and dyslipidemia significantly affected hearing recovery ( Doo et al, 2020 ; Chen et al, 2022a ; Simões et al, 2022 ).…”