HBOT and Idiopathic Sudden Sensorineural Hearing Loss
Hyperbaric oxygen therapy, or HBOT, is FDA approved for the treatment of idiopathic sudden sensorineural hearing loss. Doctors often prescribe it together with corticosteroids. A recent 2018 study looks at 2041 patients with SSNH that underwent corticosteroid treatment alone or with HBOT. The study results show that absolute hearing gain was significantly greater in patients with HBOT, especially in patients with severe to profound hearing loss at baseline.
While HBOT does work well when paired together with traditional treatments, it is also beneficial to patients as initial therapy. It also benefits patients that fail to respond to traditional treatments. A 2012 case report looked at a 37-year-old man that had idiopathic sudden sensorineural hearing loss in the left ear. After a course of corticosteroid treatments, he also developed hearing loss in the right ear. Doctors administered Intratympanic membrane steroids three times in the left ear, again showing minimal improvement. After 36 days from the initial onset, the patient decided to undergo hyperbaric oxygen therapy, or HBOT. After the third session, normal hearing returned to both ears.
What is Idiopathic Sudden Sensorineural Hearing Loss (SSHL)?
Idiopathic sudden sensorineural hearing loss is a condition where there is something wrong with the sensory organs of the inner ear or the nerve pathways between the inner ear and the brain. While 10 percent of patients will have an underlying cause for this sudden deafness, most patients do not. Many people notice the loss of hearing when they wake in the morning or some may experience a “pop” in the ear before the loss occurs. They may experience the feeling of fullness in the ear, dizziness, or ringing in the ears. The hearing loss can be immediate, or the loss can come on gradually, with sounds becoming muffled or faint.
The term idiopathic refers to a condition with no identifiable underlying cause. However, while that is the case in most hearing loss patients, some potential underlying causes include bacterial or viral infections, such as Lyme disease and syphilis, underlying autoimmune conditions such as lupus or Behcet’s disease, a traumatic injury, a metabolic disorder, such as diabetes, or an underlying neurologic condition, such as multiple sclerosis. In the majority of cases where no underlying cause is found, hypotheses include vascular compromise, a rupture of the cochlear membrane, or an unidentified viral infection.
How is Idiopathic Sudden Sensorineural Hearing Loss Diagnosed?
If you experience sudden hearing loss, your physician will run a number of tests to rule out any potential underlying cause, starting with loss due to an obstruction in the ear, such as a buildup of fluid or wax. The next test is typically pure tone audiometry, which looks at how loud frequencies need to be before you can hear them. A loss of at least 30 decibels shows signs of SSHL. In this case, normal speech levels would sound like a faint whisper.
In most cases of hearing loss where there is no known cause, the standard course of treatment is corticosteroids. These work by reducing inflammation and swelling, as well as help the body fight any possible illness. While this can be given in pill form, corticosteroids are often injected into the middle ear where it can flow into the inner ear. Other available treatments can include vasodilators, immunosuppressants, and antiviral medications. Treatment should begin as early as possible in order to avoid permanent hearing loss. After two to four weeks of onset, hearing loss is often irreversible. Early treatment with hyperbaric oxygen and HBOT helps reduce the risk of irreversible hearing loss.
If you suffer from idiopathic sudden sensorineural hearing loss and would like to see what hyperbaric oxygen and HBOT can do for you, give our office a call at 727.787.7077 to set up an initial consultation. Dr. Spiegel and his team will evaluate your medical history and set up a treatment plan that works for you. Click HERE to fill out our online request form.