Efficacy of the additional effect of hyperbaric oxygen therapy in combination of systemic steroid and prostaglandin E1 for idiopathic sudden sensorineural hearing loss

Efficacy of the additional effect of hyperbaric oxygen therapy in combination of systemic steroid and prostaglandin E₁ for idiopathic sudden sensorineural hearing loss:

Publication date: Available online 27 November 2019
Source: American Journal of Otolaryngology
Author(s): Satoshi Hara, Takeshi Kusunoki, Hirotomo Honma, Yoshinobu Kidokoro, Katsuhisa Ikeda

Abstract

Purpose

The efficacies of hyperbaric oxygen therapy (HBO), systemic steroid, prostaglandin E₁, or the combination of any two modalities have been reported in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). However, little is known about the combined efficacy of HBO, systemic steroid, and prostaglandin E₁ for this disorder. We aimed to investigate the efficacy of HBO combined with systemic steroids and prostaglandin E₁ as triple therapy in patients with ISSNHL.

Materials and methods

We retrospectively evaluated the records of 67 patients with ISSNHL who were treated with systemic steroid and prostaglandin E₁, with (n = 38) or without (n = 29) HBO. The inclusion criteria included a diagnosis of ISSNHL within 14 days of symptom onset, age ≥15 years, treatment according to the protocol, and clinical follow-up of at least 1 month. The patients' hearing levels were evaluated 1 month after hearing loss onset. The primary outcome was hearing improvement on pure tone audiometry. We also evaluated the demographic profiles of patients.

Results

Patients treated with triple therapy showed significantly greater hearing improvement (p < 0.01) than those treated without HBO, despite some differences between the two treatment groups. Multivariate logistic regression analysis revealed a significant positive correlation between pure tone audiometry improvement and hyperbaric oxygen therapy, after adjustment for confounding factors (odds ratio = 7.42; 95% and confidence interval = 2.37–23.3; p = 0.001).

Conclusion

HBO with systemic steroid and prostaglandin E₁ administration conferred significant therapeutic benefits for ISSNHL. Therefore, routine use of triple therapy is recommended for patients with ISSNHL.