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

Am J Otolaryngol. 2020 Mar-Apr;41(2):102363. doi: 10.1016/j.amjoto.2019.102363. Epub 2019 Nov 27.

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.

Keywords: Corticosteroid; Hyperbaric oxygen therapy; Idiopathic sudden sensorineural hearing loss; Prostaglandin E(1).

MeSH terms

  • Aged
  • Alprostadil / administration & dosage*
  • Audiometry, Pure-Tone
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Female
  • Hearing Loss, Sensorineural / diagnosis
  • Hearing Loss, Sensorineural / therapy*
  • Hearing Loss, Sudden / diagnosis
  • Hearing Loss, Sudden / therapy*
  • Humans
  • Hyperbaric Oxygenation*
  • Male
  • Middle Aged
  • Prednisolone / administration & dosage*
  • Retrospective Studies

Substances

  • Prednisolone
  • Alprostadil