Hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss

Objectives: The pathophysiology of idiopathic sudden sensorineural hearing loss (ISSHL) remains largely unknown. However, it is hypothesized that this disorder may be caused by reduced cochlear blood flow, labyrinth viral infections, intracochlear membrane ruptures or immune-mediated inner ear disease. Hyperbaric oxygen therapy (HBOT) may have a positive effect on ISSHL by raising intracochlear oxygen tension, stimulating angioneogenesis, and having an anti-inflammatory function. The objective of this systematic review was to examine the efficacy of HBOT as a treatment for ISSHL. Methodology: A systematic approach was applied to search for all clinical studies concerning HBOT in ISSHL in the PubMed database. Nineteen studies met the selection criteria: Results: Three out of five studies (60%) recommended adding HBOT to monotherapy with corticosteroids (CS). Four out of seven of the included studies (57%) demonstrated that adding HBOT to multi-drug therapies had a beneficial effect. Two out of two studies (100%) concluded that HBOT was significantly more effective than vasodilators. Three out of five studies (60%) showed a positive indication for the use of HBOT as salvage treatment. Conclusion: HBOT could be useful as an adjunct therapy or salvage treatment for ISSHL, although evidence is still scarce.