Vol.101 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 9 September 2008
Hyperbaric Oxygen in Combination with Other Therapies
for Idiopathic Sudden Sensorineural Hearing Loss
Hideaki Suzuki, Tsuyoshi Udaka, Koichi Hashida, Takanori Mori,
Nobuaki Hiraki, Tetsuro Wakasugi and Gunji Nagatani
(University of Occupational and Environmental Health, School of Medicine)
Hyperbaric oxygen (HBO) therapy combined with steroid administration is an effective treatment for idiopathic sudden sensorineural hearing loss (ISSNHL), but is sometimes unfeasible for patients with underlying diseases, particularly for those with steroid-intolerance. We conducted a controlled retrospective analysis of patients with ISSNHL who received HBO in combination with stellate ganglion block (SGB), prostaglandin (PG) E1, or steroid therapy in order to identify possible alternative regimens.
Three hundred and six consecutive patients with ISSNHL (average hearing levels of 5 frequencies (250-4000 Hz)≧40 dB; time from the onset of hearing loss to the start of treatment ≦30 days) were enrolled. One hundred and ten, 95, and 101 patients underwent SGB＋HBO (SGB group), PGE1＋HBO (PG group), and steroid＋HBO therapy (steroid group), respectively. Hearing recovery was evaluated by grade assessment, by hearing gain, and by hearing improvement rate compared to the unaffected contralateral ear.
The overall hearing outcome did not differ among the three groups. In patients with initial hearing levels ＜80 dB, the PG group tended to show a higher cure rate, recovery rate, hearing gain, and hearing improvement rate compared to those of the other groups. In contrast, in patients with initial hearing levels ≧80 dB, the SGB group tended to show a higher recovery rate, hearing gain, and hearing improvement rate compared to those of the other groups, and the hearing improvement rate was significantly higher in the SGB group than in the PG group (53.0±5.0％ vs. 35.3±6.8％; p＜0.05).
We concluded that both SGB＋HBO and PGE1＋HBO are promising alternative regimens for ISSNHL, and that SGB＋HBO and PGE1＋HBO are recommended for patients with initial hearing levels ≧80 dB and ＜80 dB, respectively.
Key words :hyperbaric oxygen, idiopathic sudden sensorineural hearing loss, steroid, stellate ganglion block, prostaglandin E1