Burgos-Páez A, Mayoral-Flores HO, Celis-Aguilar ÉM, López-Ramos E

Language: Spanish
References: 9
Page: 230-233
PDF size: 359.38 Kb.

ABSTRACT

Background: Sudden hearing loss is defined as loss of 30 dB in three contiguous frequencies in three days. Treatment is still controversial and includes corticosteroids, vasodilators, immunosuppressive and antiviral therapy. Recently, the hyperbaric chamber emerges as a new treatment for patients with no response to systemic and intratympanic corticosteroids.
Objective: To determine the therapeutic response of the hyperbaric chamber in patients with no response to systemic and intratympanic corticosteroids.
Material and method: A prospective study was done with patients = 18 years, refractory to systemic corticosteroids (1 mg/kg for 10 days and subsequent dose reduction) and intratympanic infiltration with dexamethasone (8 mg per week, 3 doses). 10 sessions in a hyperbaric chamber, 60 minutes each, at two atmospheres, were performed to all patients and pre and post PTA audiometry (pure-tone average) was defined as the average of 500, 1,000, 2,000 and 4,000 Hz.
Results: Four female patients were included, with mean age of 51 years. Time of progression was 15 days (onset to first consultation). PTA initial average was 55.31 dB. The final PTA was 54.6875 dB, with a difference of 0.625 dB. One patient had complete recovery, one patient slight improvement (recovery of 3.75 dB), two patients had subjective improvement of instability, but no improvement in hearing. No complications occurred.
Conclusions: Hyperbaric chamber may be effective in the treatment of sudden hearing loss refractory to systemic and intratympanic steroids, but more studies are needed to prove it.

REFERENCES

1. Cummings C, Haughey B, Thomas J, et al. Sensorineural hearing loss in adults, cummings otolaryngology head and neck surgery. 4th ed. USA: Mosby, 2010;2116-2130.

2. Bailey BJ, Tohnson JT, et al. Sudden sensory hearing loss, head and neck Surgery-otolaryngology. 4a Ed. USA, 2006;2231-2236.

3. Suzuki H, et al. Efficacy of intratympanic steroid administration on idiopathic sudden sensorineural hearing loss in comparison with hyperbaric oxygen therapy. Laryngoscope 2012;122:1154-1157.

4. Horn CE, et al. Hyperbaric oxygen therapy for sudden sensorineural hearing loss: a prospective trial of patients failing steroid and antiviral treatment. Otol Neurotol 2005;26:882-889.

5. Narozny W, et al. Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy in sudden sensorineural hearing loss treatment. Otol Neurotol 2004;25:916-923.

6. Imsuwansri T, et al. Hyperbaric oxygen therapy for sudden sensorineural hearing loss after failure from oral and intratympanic corticosteroid. Clin Exp Otorhinolaryngol 201;5:99-102.

7. Bennet MH, et al. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and thinnitus. Cochrane Database Syst Rev 2009. DOI: 10.1002/14651858.CD004739.

8. Murakawa T, Kosaka M, et al. Treatment of 522 patients with sudden deafness performed oxygenation at high pressure. Nihon Jibiinkoka Gakkai Kaiho 2000;103:506-515.

9. Aslan I, Oysu C, Veyseller B. Does the addition of hyperbaric oxygen therapy to the conventional treatment modalities influence the outcome of sudden deafness? Otolaryngol Head Neck Surg 2002;126:121-126.