Sudden Sensorineural Hearing Loss: Comparative Study of Different Treatment Modalities

Ahmed Khater Mohammad Waheed El-Anwar Ahmad Abdel-Fattah Nofal Atef Taha Elbahrawy About the authors

Abstract

Introduction

Idiopathic sudden sensorineural hearing loss (ISSNHL) is hearing loss of at least 30 dB in at least 3 contiguous frequencies within at least 72 hours. There are many different theories to explain it, and many differentmodalities are used for its management, such as: systemic steroids (SSs), intratympanic steroid injection (ITSI), hyperbaric oxygen therapy (HOT), antiviral drugs, and vasodilators or vasoactive substances.

Objectives

This study aims to evaluate the efficacy of the combination of the most common treatmentmodalities of ISSNHL and to compare the results if HOTwas not one of the treatment modalities administered.

Methods

The study was conducted with 22 ISSNHL patients with ages ranging from 34 to 58 years. The patients were divided into 2 groups; group A included 11 patients managed by SSs, ITSI, antiviral therapy, and HOT simultaneously, and group B included 11 patients exposed to the aforementioned modalities, with the exception of HOT.

Results

After one month, all of the patients in group A showed total improvement in hearing in all frequencies, with pure tone average (PTA) of 18.1 ± 2.2, while in group B, 5/11 (45.5%) patients showed total improvement, and 6 /11 (54.5%) patients showed partial improvement, with a total mean PTA of 28.1 ± 8.7.

Conclusion

The early administration of HOT in combination with other clinically approved modalities (SSs, ITSI, antiviral therapy) provides better results than the administration of the same modalities, with the exception of HOT, in the treatment of ISSNHL.

Keywords:
hearing loss; hyperbaric oxygen therapy; steroids; intratympanic injection

Introduction

Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as rapid hearing loss of at least 30 dB in at least 3 contiguous frequencies within 72 hours or less.11 O'Malley MR, Haynes DS. Sudden hearing loss. Otolaryngol Clin North Am 2008;41(03):633-649, x-xi 22 Byl FM Jr. Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope 1984;94(5 Pt 1):647-661 It was first described by De Kleyn in 1944.33 Kleyn AD. Sudden complete or partial loss of function of the octavus-system in apparently normal persons. Acta Otolaryngol 1944;32(5-6):407-429 Occasionally, it is associated with vestibular dysfunction, tinnitus and/or pressure sensation in the affected ear.44 Chen YS, Emmerling O, Ilgner J, Westhofen M. Idiopathic sudden sensorineural hearing loss in children. Int J Pediatr Otorhinolaryngol 2005;69(06):817-821

Detailed investigations can determine the cause in only 10% of the patients with sudden sensorineural hearing loss (SSNHL), while the term idiopathic is used to describe the other patients.55 Penido NO, Cruz OL, Zanoni A, Inoue DP. Classification and hearing evolution of patients with sudden sensorineural hearing loss. Braz J Med Biol Res 2009;42(08):712-716

There are different theories to explain the pathophysiology of ISSHL; viral infection, alteration in inner ear microcirculation, and immune-mediated disease are the most popular theories.66 Plaza G, Durio E, Herráiz C, Rivera T, García-Berrocal JR; Asociación Madrileña de ORL. [Consensus on diagnosis and treatment of sudden hearing loss. Asociación Madrileña de ORL]. Acta Otorrinolaringol Esp 2011;62(02):144-157 (English Edition)

The most common treatment modalities for ISSHL are one or more of the following: systemic steroids (SSs), intratympanic steroid injection (ITSI), hyperbaric oxygen therapy (HOT), antiviral drugs, and vasodilators or vasoactive substances.77 Murphy-Lavoie H, Piper S, Moon RE, Legros T. Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Undersea Hyperb Med 2012;39(03):777-792 However, the empirical uses of all of these modalities are mainly based on improving the blood circulation and restoring oxygen tension within the inner ear.88 Aslan I, Oysu C, Veyseller B, Baserer N. Does the addition of hyperbaric oxygen therapy to the conventional treatment modalities influence the outcome of sudden deafness? Otolaryngol Head Neck Surg 2002;126(02):121-126

There are only a few studies that investigate the adjuvant use of HOT in the management of ISSHL with other therapies such as SSs,77 Murphy-Lavoie H, Piper S, Moon RE, Legros T. Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Undersea Hyperb Med 2012;39(03):777-792 88 Aslan I, Oysu C, Veyseller B, Baserer N. Does the addition of hyperbaric oxygen therapy to the conventional treatment modalities influence the outcome of sudden deafness? Otolaryngol Head Neck Surg 2002;126(02):121-126 and this highlights the importance of studying the added value of HOT in cases of ISSHL, particularly in prospective and comparative studies.

The aim of this study is to assess the efficacy of the combined administration of four treatment modalities (SSs + ITSI + antiviral therapy + HOT) and to compare the results with another group of patients who was exposed to the same treatment modalities, with the exception of HOT.

Material and Methods

This prospective study was performed between February 2013 and August 2014 on 22 patients who suffered from SSNHL without detected cause after detailed examination and investigations. All of the patients provided written informed consent forms to participate in the study, and we obtained the approval of the ethics committee of our institution. All patients began the treatment within the first week of the onset of the symptoms.

Patients with history of middle ear surgery, acoustic trauma or barotrauma, fluctuating hearing loss, radiotherapy to the head and neck region, chemotherapy, exposure to an ototoxic agent, pregnant patients and patients who underwent treatment for ISSHL before entering the study protocol were excluded.

Audiological Assessment

All of the patients were evaluated for diagnosis and baseline measurements by standard methods of pure tone audiometry, air and bone conduction, as well as speech audiometry, using a GSI 61 clinical audiometer (Grason-Stadler Inc., Eden Prairie, MN US) before the treatment, and at 1 week, 2 weeks, and 1 month after the beginning of the treatment. Pure tone average (PTA) was calculated as an average of the threshold measured at 0.5 KHz, 1.0 KHz, 2.0 KHz, and 4.0 KHz (as described by Haynes et al99 Haynes DS, O'Malley M, Cohen S,Watford K, Labadie RF. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy. Laryngoscope 2007;117(01):3-15). Speech discrimination was tested by calculating the percentage of correct answers from a phonetically balanced, monosyllabic word list (Arabic version).1010 Soliman S. Speech discrimination audiometry using Arabic phonetically- balanced words. Ain Shams Med J 1976;27:27-30

Retrocochlear lesion was excluded in all patients by auditory brainstem response (ABR) (GSI Audera, Grason-Stadler Inc., Eden Prairie, MN US) and magnetic resonance imaging (MRI) with contrast of the internal auditory canal and cerebellopontine angle.

Reporting of Hearing Recovery

Total improvement was considered when the PTA at 0.5 KHz, 1.0 KHz, 2.0 KHz, and 4.0 KHz returned within 20 dB or to the same level of the unaffected contralateral ear. Partial improvement was considered when the improvement of the PTA at 0.5 KHz, 1.0 KHz, 2.0 KHz, and 4.0 KHz was ≥ 30 dB and the threshold was not within 20 dB or did not reach the level of the unaffected contralateral ear. Otherwise, the PTA was considered as not improving.

The patients were randomly allocated into 2 groups: group A (11 patients) was exposed to 4 simultaneous treatment modalities (SSs, ITSI, antiviral therapy, and HOT); and group B (11 patients) was exposed to 3 simultaneous treatment modalities (SS, ITSI, and antiviral therapy), without exposure to HOT.

Systemic steroids (SSs): in the form of oral prednisolone 1 mg/kg (maximum dose 80 mg) for 10 days, gradually decreasing the dose in the next 10 days (25% of the dose in the first 3 days, then 25% in the next 3 days, then 25% in the last 4 days, then cease to administer the medicine).

Intratympanic steroid injection (ITSI): it is administered under local anesthesia while the patient is in supine position with the head turned ∼ 30 degrees away from the surgeon. Using a syringe connected to a 22- (3.5 IN; 0.7 × 90 mm) or 25-gauge spinal needle, a 0.4-0.6 ml of methylprednisolone (Depo-medrol 40 mg/ml, EIPICO, Tanta, Gharbia, Egypt, and Pharmacia & Up John, Kalamazoo, MI, US) was injected into the tympanic cavity through the posterior-inferior quadrant of the tympanic membrane, under direct visualization through an operating microscope. The solution was heated to body temperature before the injection to avoid vertigo. The patient was kept in the described position for ∼ 30 minutes after the injection. The intratympanic injection was administered immediately once the patient was evaluated and diagnosed audiologically and after the radiological exclusion of retrocochlear lesion. One dose was administered, and the patient was evaluated after one week. If there was no improvement or partial improvement, another dose was administered.

Antiviral drug: acyclovir 500 mg TDS for 1 week.

Hyperbaric oxygen therapy (HOT): the patient breathed 100% oxygen through a mask delivery system for 60 minutes in a multiplace hyperbaric chamber (NHC-412-A, Nakamura Tekko-Sho, Tokyo, Japan) with pressurized air at 2.0 atmospheres absolute (ATA) for 20 sessions, with 1 daily session.

Bed rest and a diet with a salt restriction were advised to all patients in both groups. All patients took proton pump inhibitors (omeprazole in a dose of 40 mg/day) for gastroduodenal prophylaxis while taking the steroid.

The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS, SPSS, Inc., Chicago, IL, US) software, version 18.0. The chi-squared (χ2) test was used for the comparison of the non-parametric data, and the t-test was used for the parametric data. Values of p< 0.05 were considered statistically significant; 95% confidence intervals (95%CI) and 80% power were used.

Results

This study was conducted with 22 patients with ages ranging from 34 to 58 years (mean = 45.86 ± 6.85), 10 females and 12 males. Group A was composed of 11 patients with ages ranging from 36 to 58 years (mean = 45.9 ± 6.9), 6 females and 5 males. Group B comprised 11 patients with ages ranging from 34 to 55 years (mean = 45.8 ± 7.14), 4 females and 7 males. Therefore, both groups were matched regarding age (t = 0.0136, p= 0.9892) and sex (χ2= 0.733, p= 0.39) (Table 1). In addition to hearing loss, 5 patients presented with vertigo, and 8 patients presented with tinnitus.

Table 1
Age and sex of the two studied groups

Two weeks after the beginning of the treatment, 10 patients from group A (10/11, 90.9%) had an improvement in hearing in all frequencies (8 total improvements and 2 partial improvements), while 1 case (9.1%) showed no improvement. The mean post-treatment PTA at 0.5 KHz, 1.0 KHz, 2.0 KHz, and 4.0 KHz in group A was 18.1 ± 2.2.

In group B, total improvement in hearing in all frequencies was reported by 5/11 (45.5%) patients, and partial improvement in hearing in all frequencies was reported by 6/11 (54.5%) patients, with a total mean PTA of 28.1 ± 8.7.

Therefore, in group A, in the beginning of the treatment, more improvements in hearing were observed (χ2= 0.819, p= 0.66) in comparison with group B (Table 2).

Table 2
Statistical results of the hearing improvement 2 weeks after the beginning of the treatment

Both groups showed highly significant improvements in hearing level in the first week post-treatment hearing assessment (p< 0.0001 for both groups) (Table 3). The improvement continued to be statistically significant in the one-month post-treatment assessment (p< 0.0001 for group A, and p= 0.0076 for group B), with significant better results for group A (p= 0.0014) (Table 3).

Table 3
PTA results of 4 lines and 3 lines of treatment; before the treatment, 1 week and 1 month post-treatment

Discussion

The most common therapies to treat ISSNHL include one or more of the following: SSs, ITSI, HOT, antiviral drugs, and vasodilators or vasoactive substances.77 Murphy-Lavoie H, Piper S, Moon RE, Legros T. Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Undersea Hyperb Med 2012;39(03):777-792 1111 Shirwany NA, Seidman MD, Tang W. Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 1998;19(02):230-235

The ITSI reaches the perilymph through the semipermeable round window.1212 SahinM, Göde S, Öztürk K, Bilgen C, Ögüt MF, Kirazli T. Evaluation of adjuvant intratympanic dexamethasone administration in the treatment of sudden sensorineural hearing loss. J Int Adv Otol 2014;10(03):234-239 Although it seems to be less effective than the SS, it may be used as an additive to the SS, or even an alternative to it, especially in groups of patients with contraindications to SS (such as those suffering from peptic ulcer disease, viral hepatitis and brittle diabetes).1313 Suzuki H, Fujimura T, Shiomori T, et al. Prostaglandin E1 versus steroid in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2008;35(02):192-197 Dexamethasone or methylprednisolone are the traditional safe and effective treatments for SSNHL, with no significant difference between them. In the current study, intratympanic methylprednisolone was administered to both groups to fix all administered treatment lines except HOT, in order to study its effect.1414 Dallan I, De Vito A, Fattori B, et al. Intratympanic methylprednisolone in refractory sudden hearing loss: a 27-patient case series with univariate and multivariate analysis. Otol Neurotol 2010; 31(01):25-30 1515 Yang J, Huang L, Shi J, Li Y, Wu H, Kong W. [The effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010;24(13):594-597

Hyperbaric oxygen therapy has been investigated as a treatment for hearing loss since the 1970s.1616 De Heyn G, Van Opstal M. [Comparative study of acoustic trauma caused by blasts, treated by vasodilators or by a combination of International Archives of Otorhinolaryngology Vol. 22 No. 3/2018 Sudden 248 Sensorineural Hearing Loss Khater et al. vasodilators and hyperbaric oxygenation]. Acta Otorhinolaryngol Belg 1976;30(03):251-259 1717 Giger HL. [Therapy of sudden deafness with O2/CO2 inhalation (author's transl)]. HNO 1979;27(03):107-109 The effect of HOT in ISSNHL is mostly related to its ability to correct the perilymph hypoxia by increasing the partial oxygen pressure, the oxygen concentration in the inner ear, and by improving the microcirculation and the blood profile.1818 Lamm K, Lamm H, Arnold W. Effect of hyperbaric oxygen therapy in comparison to conventional or placebo therapy or no treatment in idiopathic sudden hearing loss, acoustic trauma, noise-induced hearing loss and tinnitus. A literature survey. Adv Otorhinolaryngol 1998;54:86-99 Hyperbaric oxygen therapy has also a complex effect on the immunity due to its anti-inflammatory and anti-edematous effect, and because it blunts the ischemia reperfusion injury.77 Murphy-Lavoie H, Piper S, Moon RE, Legros T. Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Undersea Hyperb Med 2012;39(03):777-792 1919 Gill AL, Bell CN. Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM 2004;97(07):385-395

The addition of HOT improves ISSNHL outcomes, especially when administered early.1414 Dallan I, De Vito A, Fattori B, et al. Intratympanic methylprednisolone in refractory sudden hearing loss: a 27-patient case series with univariate and multivariate analysis. Otol Neurotol 2010; 31(01):25-30 In three Cochrane meta-analyses; the administration of HOT significantly improved the hearing in cases of ISSNHL, especially among patients who presented as soon as the onset of the symptoms.2020 Bennett MH, Kertesz T, Yeung P. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2005;25(01):CD004739 2121 Bennett MH, Kertesz T, Yeung P. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2007;24(01):CD004739 2222 Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2012;10:CD004739

Many viruses have been postulated as possible causes of SSNHL, and this supports the viral therapy for the pathogenesis, even though the serological, epidemiological, and histopathological data are not conclusive.2323 Schreiber BE, Agrup C, Haskard DO, Luxon LM. Sudden sensorineural hearing loss. Lancet 2010;375(9721):1203-1211

The effect of vasodilators and vasoactive substances in the treatment of ISSHL was not proven in a Cochrane review,2424 Agarwal L, Pothier DD. Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2009;7(04):CD003422 so we excluded it in the present study.

In the current study, we administered a combination of all clinically approved drugs in patients with ISSNHL within the first week of the onset of the symptoms. The patients in group A were exposed to 4 simultaneous treatment modalities (SSs, ITSI, antiviral therapy, and HOT), and the patients in group B were exposed to the same treatment modalities, with the exception of HOT. Although there was an extremely significant improvement in hearing after one month in both groups, group A showed a more significantly improvement in hearing by PTA (p= 0.0124) in comparison with group B.

In the study by Ohno et al,2525 Ohno K, Noguchi Y, Kawashima Y, Yagishita K, Kitamura K. Secondary hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss in the subacute and chronic phases. J Med Dent Sci 2010;57(02):127-132 although HOT showed no statistical difference in the control group when it was administered after the conventional treatment, this was mostly due to the late administration (more than 4 weeks after the onset of ISSNHL). Therefore, we recommend the early and simultaneous administration of HOT with other clinically approved drugs. Similarly, there are many studies that showed better hearing outcomes with HOT if the therapy is administered along with the onset of the symptoms.1616 De Heyn G, Van Opstal M. [Comparative study of acoustic trauma caused by blasts, treated by vasodilators or by a combination of International Archives of Otorhinolaryngology Vol. 22 No. 3/2018 Sudden 248 Sensorineural Hearing Loss Khater et al. vasodilators and hyperbaric oxygenation]. Acta Otorhinolaryngol Belg 1976;30(03):251-259 1818 Lamm K, Lamm H, Arnold W. Effect of hyperbaric oxygen therapy in comparison to conventional or placebo therapy or no treatment in idiopathic sudden hearing loss, acoustic trauma, noise-induced hearing loss and tinnitus. A literature survey. Adv Otorhinolaryngol 1998;54:86-99 2020 Bennett MH, Kertesz T, Yeung P. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2005;25(01):CD004739 2121 Bennett MH, Kertesz T, Yeung P. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2007;24(01):CD004739 2222 Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2012;10:CD004739 2626 Nakashima T, Fukuta S, Yanagita N. Hyperbaric oxygen therapy for sudden deafness. Adv Otorhinolaryngol 1998;54:100-109

In many studies,2525 Ohno K, Noguchi Y, Kawashima Y, Yagishita K, Kitamura K. Secondary hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss in the subacute and chronic phases. J Med Dent Sci 2010;57(02):127-132 2727 Desloovere C, Knecht R, Germonpré P. Hyperbaric oxygen therapy after failure of conventional therapy for sudden deafness. B-ENT 2006;2(02):69-73 2828 Muzzi E, Zennaro B, Visentin R, Soldano F, Sacilotto C. Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: review of rationale and preliminary report. J Laryngol Otol 2010;124(02):e2 HOT was administered as a salvage treatment after an ineffective previous treatment of ISSNHL, but in the present study we administered it since the beginning of the treatment in combination with other clinically approved modalities (SSs, ITSI and antiviral drugs) in patients who presented as soon as the onset of ISSNHL symptoms.

Although there are some studies1818 Lamm K, Lamm H, Arnold W. Effect of hyperbaric oxygen therapy in comparison to conventional or placebo therapy or no treatment in idiopathic sudden hearing loss, acoustic trauma, noise-induced hearing loss and tinnitus. A literature survey. Adv Otorhinolaryngol 1998;54:86-99 2929 Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86(4 Pt 1):463-480 3030 Stachler RJ, Chandrasekhar SS, Archer SM, et al; American Academy of Otolaryngology-Head and Neck Surgery. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012;146(3, Suppl)S1-S35 that report a high incidence of spontaneous recovery rates for ISSNHL, because of its serious bad influence in the quality of life, we cannot just wait and see, or treat it with laxity. Therefore, we recommend the management of ISSNHL with all possible clinically approved methods, including the early administration of HOT. However, further studies with larger samples are still needed.

The current study found that the combination of HOT with other treatment modalities, such as SSs, ITSI, and antiviral therapy, showed better results in restoring hearing.

Conclusion

Although the early combined administration of SSs, ITSI, and antiviral therapy significantly improved the hearing levels of patients with ISSNHL, the combination of HOT with these treatment modalities showed better results.

References

  • 1
    O'Malley MR, Haynes DS. Sudden hearing loss. Otolaryngol Clin North Am 2008;41(03):633-649, x-xi
  • 2
    Byl FM Jr. Sudden hearing loss: eight years' experience and suggested prognostic table. Laryngoscope 1984;94(5 Pt 1):647-661
  • 3
    Kleyn AD. Sudden complete or partial loss of function of the octavus-system in apparently normal persons. Acta Otolaryngol 1944;32(5-6):407-429
  • 4
    Chen YS, Emmerling O, Ilgner J, Westhofen M. Idiopathic sudden sensorineural hearing loss in children. Int J Pediatr Otorhinolaryngol 2005;69(06):817-821
  • 5
    Penido NO, Cruz OL, Zanoni A, Inoue DP. Classification and hearing evolution of patients with sudden sensorineural hearing loss. Braz J Med Biol Res 2009;42(08):712-716
  • 6
    Plaza G, Durio E, Herráiz C, Rivera T, García-Berrocal JR; Asociación Madrileña de ORL. [Consensus on diagnosis and treatment of sudden hearing loss. Asociación Madrileña de ORL]. Acta Otorrinolaringol Esp 2011;62(02):144-157 (English Edition)
  • 7
    Murphy-Lavoie H, Piper S, Moon RE, Legros T. Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Undersea Hyperb Med 2012;39(03):777-792
  • 8
    Aslan I, Oysu C, Veyseller B, Baserer N. Does the addition of hyperbaric oxygen therapy to the conventional treatment modalities influence the outcome of sudden deafness? Otolaryngol Head Neck Surg 2002;126(02):121-126
  • 9
    Haynes DS, O'Malley M, Cohen S,Watford K, Labadie RF. Intratympanic dexamethasone for sudden sensorineural hearing loss after failure of systemic therapy. Laryngoscope 2007;117(01):3-15
  • 10
    Soliman S. Speech discrimination audiometry using Arabic phonetically- balanced words. Ain Shams Med J 1976;27:27-30
  • 11
    Shirwany NA, Seidman MD, Tang W. Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 1998;19(02):230-235
  • 12
    SahinM, Göde S, Öztürk K, Bilgen C, Ögüt MF, Kirazli T. Evaluation of adjuvant intratympanic dexamethasone administration in the treatment of sudden sensorineural hearing loss. J Int Adv Otol 2014;10(03):234-239
  • 13
    Suzuki H, Fujimura T, Shiomori T, et al. Prostaglandin E1 versus steroid in combination with hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2008;35(02):192-197
  • 14
    Dallan I, De Vito A, Fattori B, et al. Intratympanic methylprednisolone in refractory sudden hearing loss: a 27-patient case series with univariate and multivariate analysis. Otol Neurotol 2010; 31(01):25-30
  • 15
    Yang J, Huang L, Shi J, Li Y, Wu H, Kong W. [The effect of intratympanic dexamethasone or methylprednisolone on treatment of sudden sensorineural hearing loss]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010;24(13):594-597
  • 16
    De Heyn G, Van Opstal M. [Comparative study of acoustic trauma caused by blasts, treated by vasodilators or by a combination of International Archives of Otorhinolaryngology Vol. 22 No. 3/2018 Sudden 248 Sensorineural Hearing Loss Khater et al. vasodilators and hyperbaric oxygenation]. Acta Otorhinolaryngol Belg 1976;30(03):251-259
  • 17
    Giger HL. [Therapy of sudden deafness with O2/CO2 inhalation (author's transl)]. HNO 1979;27(03):107-109
  • 18
    Lamm K, Lamm H, Arnold W. Effect of hyperbaric oxygen therapy in comparison to conventional or placebo therapy or no treatment in idiopathic sudden hearing loss, acoustic trauma, noise-induced hearing loss and tinnitus. A literature survey. Adv Otorhinolaryngol 1998;54:86-99
  • 19
    Gill AL, Bell CN. Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM 2004;97(07):385-395
  • 20
    Bennett MH, Kertesz T, Yeung P. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2005;25(01):CD004739
  • 21
    Bennett MH, Kertesz T, Yeung P. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2007;24(01):CD004739
  • 22
    Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev 2012;10:CD004739
  • 23
    Schreiber BE, Agrup C, Haskard DO, Luxon LM. Sudden sensorineural hearing loss. Lancet 2010;375(9721):1203-1211
  • 24
    Agarwal L, Pothier DD. Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev 2009;7(04):CD003422
  • 25
    Ohno K, Noguchi Y, Kawashima Y, Yagishita K, Kitamura K. Secondary hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss in the subacute and chronic phases. J Med Dent Sci 2010;57(02):127-132
  • 26
    Nakashima T, Fukuta S, Yanagita N. Hyperbaric oxygen therapy for sudden deafness. Adv Otorhinolaryngol 1998;54:100-109
  • 27
    Desloovere C, Knecht R, Germonpré P. Hyperbaric oxygen therapy after failure of conventional therapy for sudden deafness. B-ENT 2006;2(02):69-73
  • 28
    Muzzi E, Zennaro B, Visentin R, Soldano F, Sacilotto C. Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: review of rationale and preliminary report. J Laryngol Otol 2010;124(02):e2
  • 29
    Mattox DE, Simmons FB. Natural history of sudden sensorineural hearing loss. Ann Otol Rhinol Laryngol 1977;86(4 Pt 1):463-480
  • 30
    Stachler RJ, Chandrasekhar SS, Archer SM, et al; American Academy of Otolaryngology-Head and Neck Surgery. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012;146(3, Suppl)S1-S35

Publication Dates

  • Publication in this collection
    Jul-Sep 2018

History

  • Received
    24 Sept 2016
  • Accepted
    03 July 2017
Fundação Otorrinolaringologia R. Teodoro Sampaio, 483, 05405-000 São Paulo/SP Brasil, Tel.: (55 11) 3068-9855, Fax: (55 11) 3079-6769 - São Paulo - SP - Brazil
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