Sudden deafness: the effectiveness of hyperbaric oxygen therapy combined to systemic corticosteroid treatment

##plugins.themes.academic_pro.article.main##

Chiraz Halwani
Senda Turki
Hédi Gharsallah

Abstract

Summary
Introduction: Sudden idiopathic deafness is a sensorineural emergency, requiring rapid therapeutic initiation. The treatments are very varied, with disparate results.
 Aim : evaluate our results in the treatment of sudden deafness and the effectiveness of hyperbaric oxygen therapy (HBOT) combined to systemic corticosteroid treatment. Methods: We report a series of 42 patients treated in our department with sudden deafness diagnosed on clinical and paraclinical arguments collected over a period of ten years. A statistical analysis was performed looking for a statistically significant relationship between an improvement after treatment and the use of an HBOT. Results: The mean age of our patients was 44 years with ranges of 8 to 78 years. These were 28 men (67%) and 14 women (33%). Our patients consulted urgently for sudden onset deafness in all cases, accompanied by acute ringing in the ears in 81%. In tonal audiometry, the hearing threshold varied between 35 and 100 dB with an average of 64dB. The type of curve was: A (19%), B (7%), C (43%), D (5%) and E (26%). The patients were treated with HBOT in 81% of cases, the number of sessions varied between 0 and 20 with an average of 10 sessions. The post-treatment hearing threshold varied between 10 and 100 with an average of 45dB. Improvement was obtained in 81% of cases. Hearing gain varied between 0 and 60db with an average of 20dB. Improvement was obtained in 30 patients treated with HBOT and in 4 patients who did not receive HBOT. The comparison of these two groups showed a statistically significant difference (p = 0.013).
Conclusions: Sudden deafness is an indication of HBOT retained for several decades on the basis that the pressure which reigns within a hyperbaric chamber would compensate for the observed damage of the ear. Our study supports this indication.

Keywords:

Deafness, Sudden deafness, Treatment, Hyperbaric oxygen

##plugins.themes.academic_pro.article.details##

References

  1. 1. Vijayendra H, Buggaveeti G, Parikh B, Sangitha R. Sudden sensorineural hearing loss: an otologic emergency. Indian J Otolaryngol Head Neck Surg. 2012;64(1):1-4. 2. López González MA, Cambil E, Abrante A, López Fernández R, Esteban F. Sound therapy in sudden deafness. Acta Otorrinolaringol Esp. 2012;63(3):165-72. 3. Zhang X, Xu X, Ma W, Zhang Q, Tong B, Yu H, et al. A clinical study of sudden deafness. Acta Otolaryngol. 2015;135:1030-5. 4. Westerlaken BO, Stokroos RJ, Dhooge IJM, Wit HP, Albers FJ. Treatment of idiopathic sudden sensorineural hearing loss with antiviral therapy. Ann Otol Rhinol Laryngol. 2003;112 (11):993-1000. 5. Maffert A. sudden deafness, descriptive study on 60 files, analysis of the care pathway and place of the attending physician [Thesis]. Medicine: Paris;2009. 6. Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM, et al. Clinical Practice Guideline: Sudden Hearing Loss. Otolaryngol Neck Surg 2012;146:S1-35. 7. Eryigit B, Ziylan F, Yaz F, Thomeer HM. The effectiveness of hyperbaric oxygen in patients with idiopathic sudden sensorineural hearing loss: a systematic review. Eur Arch Otorhinolaryngol. 2018;275(12):2893-904. 8. Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med 2017;47(1):24-32. 9. Murphy Lavoie H, Piper S, Moon RE, Legros T. Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Undersea Hyperb Med. 2012; 39(3):777-92. 10. Suzuki M, Hashimoto S, Kano S, Okitsu T. Prevalence of acoustic neuroma associated with each configuration of pure tone audiogram in patients with asymmetric sensorineural hearing loss. Ann Otol Rhinol Laryngol. 2010;119(9):615-8.