title: Hyperbaric oxygen therapy for sudden sensorineural hearing loss: a prospective trial of patients failing steroid and antiviral treatment.
abstract: OBJECTIVE
  To investigate the safety and efficacy of hyperbaric oxygen therapy (HBOT) in adult patients with sudden sensorineural hearing loss (SSNHL) who fail standard of care steroid and antiviral therapy.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  An urban tertiary referral center.
  
  
  METHODS
  Nine adult patients presenting with SSNHL from December 2002 through February 2004. Patients with acute onset SSNHL of greater than 30 dB in three contiguous frequencies who failed to show audiometric improvement after 2 weeks of systemic steroids and antivirals were enrolled.
  
  
  METHODS
  Study patients received HBOT at 2.0 atmospheric pressure for 90 minutes while breathing 100% oxygen under a clear plastic hood in the chamber. Treatments were administered daily for 10 days over a 2-week period.
  
  
  METHODS
  Pre-and postHBOT mean hearing gains measured in decibels for pure-tone audiometry at 0.5, 1, 2, 3, and 4 KHz for bone and additional 8 KHz for air; pure-tone averages for air and bone; speech reception thresholds; and speech discrimination levels. Patient-reported subjective recovery rates (completely, substantially, partially, not improved) were also recorded.
  
  
  RESULTS
  Overall, two patients had a dramatic improvement, and one patient had a dramatic improvement in his speech discrimination without improvement in other audiometric measures. Six patients had no demonstrable hearing gains. Two patients had complications of serous otitis media requiring myringotomy and pressure equalizing tube placement. No other complications were observed.
  
  
  CONCLUSIONS
  Secondary HBOT after failure of systemic steroid and antiviral therapy may be associated with hearing gains in some patients with SSNHL.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Weill Medical College, Cornell University, New York, New York 10021, USA.
authors.forename: Corinne E
authors.initials: CE
authors.lastname: Horn
authors.forename: Harvey N
authors.initials: HN
authors.lastname: Himel
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Selesnick
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D015331:Cohort Studies; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000628:therapy*; D003639:Hearing Loss, Sudden / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013067:Speech Perception; D016896:Treatment Outcome