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Sanda N, Sawabe M, Kabaya K, Kawaguchi M, Fukushima A, Nakamura Y, Maseki S, Niwa M, Mori H, Hyodo Y, Nishiyama K, Kawakita D, Iwasaki S. Clinical impact of hyperbaric oxygen therapy combined with steroid treatment for sudden sensorineural hearing loss: A case-control study. Laryngoscope Investig Otolaryngol 2024; 9:e1297. [PMID: 38974601 PMCID: PMC11222663 DOI: 10.1002/lio2.1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/04/2024] [Accepted: 06/08/2024] [Indexed: 07/09/2024] Open
Abstract
Objectives The aim of present study was to evaluate the clinical efficacy of hyperbaric oxygen therapy (HBOT) as a primary therapy combined with standard systemic corticosteroid treatment for sudden sensorineural hearing loss (SSNHL) compared to treatment without the use of HBOT (non-HBOT) through clinical data and advanced analytical approaches. Study Design Case-control study. Methods Conducted across three Japanese medical centers involving 298 SSNHL patients diagnosed between 2020 and 2023. Inclusion criteria encompassed first onset and treatment, WHO grade 3 or 4 initial hearing impairment, receipt of systemic corticosteroid therapy within 14 days of symptom onset, and initiation of HBOT within the same timeframe for the case group. The primary outcome measure was the difference in hearing improvement (mean hearing level in decibels, dB) between the two groups, assessed by pure-tone audiometry at baseline and 3 months post-treatment, using the inverse probability of treatment weighting (IPTW) method adjusted for covariate differences. Results The study included 67 patients in the HBOT group and 68 in the non-HBOT group. The HBOT group exhibited significantly greater hearing improvement (IPTW-adjusted difference: 7.6 dB, 95% CI 0.4-14.7; p = 0.038). Patients without vertigo in the HBOT group demonstrated substantial hearing improvement (11.5 dB, 95% CI 2.3-20.6; p = 0.014), whereas those with vertigo showed no significant improvement (-1.8 dB, 95% CI -11.8-8.3; p = 0.729). The HBOT group also had a significantly higher association with complete recovery (IPTW-adjusted odds ratio: 2.57, 95% CI 1.13-5.85; p = 0.025). Conclusion In SSHNL, HBOT combination therapy yielded slightly but significantly improved hearing outcomes compared to non-HBOT treatment. Level of Evidence 4.
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Affiliation(s)
- Naoya Sanda
- Department of OtorhinolaryngologyToyota Kosei HospitalToyotaJapan
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of MedicineNagoyaJapan
| | - Michi Sawabe
- Department of OtorhinolaryngologyToyota Kosei HospitalToyotaJapan
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of MedicineNagoyaJapan
| | - Kayoko Kabaya
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of MedicineNagoyaJapan
| | - Momoko Kawaguchi
- Department of OtorhinolaryngologyJapanese Red Cross Society Aichi Medical Center Nagoya Daini HospitalNagoyaJapan
| | - Akina Fukushima
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of MedicineNagoyaJapan
| | - Yoshihisa Nakamura
- Department of OtorhinolaryngologyJapanese Red Cross Society Aichi Medical Center Nagoya Daini HospitalNagoyaJapan
| | | | - Masaki Niwa
- Department of OtorhinolaryngologyToyota Kosei HospitalToyotaJapan
| | - Hiroki Mori
- Department of OtorhinolaryngologyToyota Kosei HospitalToyotaJapan
| | - Yoshiyuki Hyodo
- Department of Clinical Engineering TechnologyToyota Kosei HospitalToyotaJapan
| | - Kazuyoshi Nishiyama
- Department of Clinical Engineering TechnologyToyota Kosei HospitalToyotaJapan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of MedicineNagoyaJapan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck SurgeryNagoya City University Graduate School of MedicineNagoyaJapan
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Alter IL, Hamiter M, Lalwani AK. Is Hyperbaric Oxygen Effective in the Treatment of Sudden Sensorineural Hearing Loss? Laryngoscope 2024; 134:504-506. [PMID: 37658746 DOI: 10.1002/lary.31002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Isaac L Alter
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, U.S.A
| | - Mickie Hamiter
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, U.S.A
- Department of Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian/Weill Cornell Medicine, New York, New York, U.S.A
| | - Anil K Lalwani
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, U.S.A
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Kim H, Kong SK, Kim J, Lee HM, Choi SW, Lee IW, Oh SJ. The Optimized Protocol of Hyperbaric Oxygen Therapy For Sudden Sensorineural Hearing Loss. Laryngoscope 2023; 133:383-388. [PMID: 35548932 DOI: 10.1002/lary.30181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/05/2022] [Accepted: 04/30/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to determine the optimal protocol of hyperbaric oxygen therapy (HBOT) according to various treatment settings for sudden sensorineural hearing loss (SSNHL). METHODS A 112 patients with SSNHL were enrolled in this prospective study. All patients were treated with systemic steroid therapy, intratympanic steroid therapy, and HBOT. According to the pressure and duration of HBOT (10 sessions in total), the patients were divided into three groups: group 1, 2.5 atmospheres absolute (ATA) for 1 h; group 2, 2.5 ATA for 2 h; and group 3, 1.5 ATA for 1 h. The pure-tone average (PTA), word discrimination score (WDS), and mean gain were compared. RESULTS A total of 105 patients completed the 3-month follow-up, and 6 patients were excluded. Differences among groups were found in PTA, WDS, and mean gain. In the post-hoc analysis, group 3 had significantly lower WDS and mean gain than groups 1 and 2; however, group 2 showed no significant differences from group 1. The proportion of patients with hearing recovery after treatment was significantly higher in group 1 (57.6%) and group 2 (58.8%) than in group 3 (31.3%). CONCLUSIONS When HBOT (10 sessions) was combined with corticosteroids as the initial therapy for SSNHL, a higher pressure (1.5 ATA vs. 2.5 ATA) provided better treatment results; however, increasing the duration (1 h vs. 2 h) under 2.5 ATA did not result in a significant difference. Therefore, HBOT for SSNHL may be performed at 2.5 ATA for 1 h in 10 sessions. Laryngoscope, 133:383-388, 2023.
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Affiliation(s)
- Hwabin Kim
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Soo-Keun Kong
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.,Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea
| | - Jia Kim
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyun-Min Lee
- Department of Otorhinolaryngology and Biomedical Research Institute, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea
| | - Sung-Won Choi
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea.,Department of Otorhinolaryngology and Biomedical Research Institute, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea
| | - Se-Joon Oh
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.,Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea
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Xie W, Karpeta N, Tong B, Liu Y, Zhang Z, Duan M. Comorbidities and laboratory changes of sudden sensorineural hearing loss: a review. Front Neurol 2023; 14:1142459. [PMID: 37144001 PMCID: PMC10151530 DOI: 10.3389/fneur.2023.1142459] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/29/2023] [Indexed: 05/06/2023] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is defined as an abrupt hearing loss of more than 30 dB in three contiguous frequencies within 72 h. It is an emergency disease requiring immediate diagnosis and treatment. The incidence of SSNHL in Western countries' population is estimated between 5 and 20 per 1,00,000 inhabitants. The etiology of SSNHL remains unknown. Due to the uncertainty of the cause of SSNHL, at present, no specific treatment targets the cause of SSNHL, resulting in poor efficacy. Previous studies have reported that some comorbidities are risk factors for SSNHL, and some laboratory results may provide some clues for the etiology of SSNHL. Atherosclerosis, microthrombosis, inflammation, and the immune system may be the main etiological factors for SSNHL. This study confirms that SSNHL is a multifactorial disease. Some comorbidities, such as virus infections, are suggested to be the causes of SSNHL. In summary, by analyzing the etiology of SSNHL, more targeting treatments should be used to achieve a better effect.
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Affiliation(s)
- Wen Xie
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Niki Karpeta
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otolaryngology-Head and Neck Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Busheng Tong
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Anhui, Hefei, China
| | - Yuehui Liu
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhilin Zhang
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Maoli Duan
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otolaryngology-Head and Neck Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- *Correspondence: Maoli Duan
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Dova S, Psillas G, Tsaligopoulos M, Nikolaidis V, Stefanidou S, Karagiannis G, Kotsiou M, Kaltzidis T, Markou K. The effectiveness of hyperbaric oxygen therapy on the final outcome of patients with sudden sensorineural hearing loss. Am J Otolaryngol 2022; 43:103564. [DOI: 10.1016/j.amjoto.2022.103564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/27/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
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Update on the Management of Idiopathic Sudden Sensorineural Hearing Loss. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00414-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Kwak C, Seo YJ, Yoon C, Lee J, Han W. The value of having an initial word recognition score for a precise prognosis of idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2021; 49:554-563. [PMID: 34772562 DOI: 10.1016/j.anl.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Although the hearing thresholds of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) closely relate to the prognosis that results in progressive floor effects, many studies have usually used hearing thresholds as the main outcome of the measurement of prognostic factors. The present study aimed to identify the prognostic factors related to initial hearing tests and speculates the effects of word recognition score (WRS) on the prognoses for patients with ISSNHL. METHODS Between March 2011 and November 2020, we retrospectively reviewed chart profiles of 2,636 ISSNHL patients. The 180 patients who met the inclusion criteria were asked to participate in the present study. Based on their initial WRS, all these patients were divided into good WRS (GW) and poor WRS (PW) groups with 52% as the cut-off points. Demographic, clinical, and audiological variables, such as age, onset time, duration of treatment, gender, ear side, comorbidities (i.e., hypertension, diabetes mellitus, tinnitus, dizziness), hearing configuration (i.e., ascending, descending, flat, irregular, and profound), treatment options (i.e., systemic corticosteroid therapy per oral, intratympanic steroid injection, and hyperbaric oxygen therapy), and WRS were analyzed as being underlying prognostic factors. RESULTS Both groups showed significantly different distributions for hearing thresholds and hyperbaric oxygen therapy (HBOT) as general characteristics. The results of a multivariate logistic regression analysis showed that the odds ratio (OR) of age (OR: 0.96, 95% CI: 0.59 - 24.25), duration of treatment (OR: 0.98, 95% CI: 0.96 - 1.00), ascending configuration (OR: 4.97, 95% CI: 1.64 - 16.62), irregular configuration (OR: 4.58, 95% CI: 1.62 - 13.79), and WRS (OR: 1.01, 95% CI: 1.00 - 1.02) were the significant prognostic factors for all the patients. Further analysis of those patients with WRS under 52% cut-off points showed that an ascending configuration (OR: 5.87, 95% CI: 1.18 - 35.99), irregular configuration (OR: 8.03, 95% CI: 1.69 - 46.30), and WRS (OR: 1.05, 95% CI: 1.01 - 1.10) significantly affected the prognosis. As the initial WRS of ISSNHL patients decreased, the OR of the WRS itself increased. These results suggested that the importance of WRS as the prognostic factor was stressed for PW patients. CONCLUSION The age, duration of treatment, initial hearing configuration (ascending and irregular types), and WRS were the significant prognostic factors for patients with ISSNHL. It was learned that WRS could be a remarkable prognostic factor to consider, especially for ISSNHL patients with poor WRS.
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Affiliation(s)
- Chanbeom Kwak
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea; Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea
| | - Young Joon Seo
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju, Korea; Research Institute of Hearing Enhancement, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - ChulYoung Yoon
- Department of biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - JuHyung Lee
- Department of biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Woojae Han
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea; Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon, Korea.
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