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

INTRODUCTION: Sudden idiopathic deafness is a sensorineural emergency, requiring rapid therapeutic initiation. The treatments are very varied, with disparate results. AIM: To 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). CONCLUSION: 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. KEY WORDS: Deafness, Sudden deafness, Treatment, Hyperbaric oxygen