Med-Ok Hyperbaric Oxygen Therapy Center, Tatlıpınar cad. No: 7/1, 34093, Şehremini-Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2011 Jan;268(1):41-7. doi: 10.1007/s00405-010-1336-6. Epub 2010 Jul 14.
Idiopathic sudden sensorineural hearing loss (ISSNHL) is an otologic emergency with an incidence of about 5-20 per 100,000 of the population per year. There is no universally accepted standard protocol for the treatment of patients with ISSNHL. Hyperbaric oxygen therapy (HBOT), was first reported to improve the outcome following acute inner ear disorders during the late 1960s by both French and German authors. The increase in perilymph oxygenation produced by HBOT provides logical basis for the use of this treatment modality in ISSNHL. We reviewed the records of 97 cases that received HBOT for SSNHL to identify the factors that may affect the treatment outcomes. The effects of age, gender, affected ear, status of the contralateral ear, symptoms associated with hearing loss, presence of a cardiovascular disease, dyslipidemia, history of diabetes mellitus, seasonal factor, smoking, degree of hearing loss, audiogram type, medical treatments provided prior to HBOT, onset time, and number of HBOT sessions were evaluated. The mean hearing gain in all cases after the HBOT was 29.5 dB. The gains were statistically significant in the following cases: early onset of HBOT (p = 0.016), higher number of HBOT sessions (p < 0.01), steroid usage (p = 0.009), low frequency-ascending and total audiogram configuration (p < 0.01) and profound hearing loss (p = 0.011). The success rate was significantly lower in cases with high frequency-descending audiogram configuration (p < 0.001). The most important factor affected the prognosis favorably was found as steroid therapy. This retrospective study and our clinical experience suggest that HBOT has beneficial effects when administered in the early phase of the disease together with steroids. HBOT is a safe practice when used properly by an experienced hyperbaric team. In the treatment of ISSNHL, 20 sessions of HBOT at 2.5 ATA can be tolerated well besides some minor side effects. HBOT should be considered for the cases especially with total or profound hearing loss.
特发性突发性聋（ISSNHL）是一种耳科急症，其发病率为每年每 10 万人中有 5-20 人。目前，对于 ISSNHL 患者的治疗，尚无普遍接受的标准方案。高压氧治疗（HBOT）于 20 世纪 60 年代末由法国和德国的作者首次报道可改善急性内耳疾病的预后。HBOT 增加了外淋巴液中的氧分压，为这种治疗方式在 ISSNHL 中的应用提供了合理的依据。我们回顾了 97 例接受 HBOT 治疗的 SSNHL 患者的记录，以确定可能影响治疗效果的因素。评估了年龄、性别、患耳、对侧耳状况、听力损失相关症状、心血管疾病、血脂异常、糖尿病史、季节因素、吸烟、听力损失程度、听力图类型、HBOT 前的药物治疗、发病时间和 HBOT 疗程数等因素的影响。所有病例 HBOT 后平均听力提高 29.5dB。以下情况下的听力提高有统计学意义：HBOT 发病较早（p=0.016），HBOT 疗程数较多（p<0.01），使用类固醇（p=0.009），低频上升和总听力图构型（p<0.01），以及重度听力损失（p=0.011）。高频下降听力图构型的病例成功率明显较低（p<0.001）。对预后有积极影响的最重要因素是类固醇治疗。这项回顾性研究和我们的临床经验表明，HBOT 与类固醇联合应用于疾病早期具有有益的效果。由经验丰富的高压氧团队正确使用 HBOT 是安全的。在 ISSNHL 的治疗中，2.5ATA 下 20 次 HBOT 除了一些轻微的副作用外，患者都能耐受。对于总聋或深度聋的病例，应考虑使用 HBOT。
