Sensorineural Hearing Loss

Hyperbaric Oxygen Therapy Approval Status

Yes Clearance by US Food and Drug Administration (FDA)

Yes Approval by the Undersea and Hyperbaric Medical Society (UHMS)

About Clearance and Approval

 

Definition and Causes

Sensorineural hearing loss, or nerve-related deafness, is a sudden or rapidly progressive loss of hearing related to problems with the inner ear and the nerves that connect the ear to the brain. Sudden hearing loss is commonly defined as a reduction in sound volume greater than 30 dB (decibels) across three connected frequencies in a 72-hour period.

Doctors and patients cannot usually pinpoint a specific cause for sensorineural hearing loss. Researchers have confirmed a strong association with circulatory problems or lack of oxygen in the inner ear. Other possible causes include heredity, viral and bacterial infection, toxins, growths or tumors, poor nutrition, injury or trauma, nervous system disorders, and exposure to loud noise.

As many as 20 per 100,000 people per year experience sensorineural hearing loss. Nearly all cases (9 in 10) involve only one ear. Hearing loss is often accompanied by dizziness or ringing in the ear (tinnitus). Many recover without treatment, but swift medical attention increases the chances for partial or full restoration of hearing.

Evidence Index

Approved
FDA cleared, widely reimbursed
Compelling
Strong body of evidence
Promising
Repeatedly favorable results
Scant
Early or mixed results
None
Unfavorable or no evidence
Disproved
Strong evidence against HBOT

Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is indicated for the treatment of idiopathic sudden sensorineural hearing loss. Idiopathic means the exact cause is unknown. Sudden means the loss develops all at once or over a few days. HBOT increases oxygen tension in the blood and tissues and dissolves extra oxygen in the blood plasma to better supply the structures, fluids, and nerves of the inner ear. Physicians may prescribe HBOT in conjunction with corticosteroids to reduce inflammation and swelling. Hyperbaric oxygen has not been shown to be helpful in treating tinnitus or chronic hearing loss beyond 6 months.

In the supporting medical literature, dosages generally ranged from 2.0 ATA to 2.5 ATA, for 60 to 90 minutes, once or twice daily, with 5 to 20 total treatments, in combination with oral corticosteroids.

Read the page Idiopathic Sudden Sensorineural Hearing Loss on the Undersea and Hyperbaric Medical Society website to learn more about sudden hearing loss, the rationale for hyperbaric oxygen therapy, and key clinical evidence, outcomes, and success factors.

HyperbaricLink Commentary

The Board of Directors of the Undersea and Hyperbaric Medical Society approved the use of hyperbaric oxygen therapy for the treatment of idiopathic sudden sensorineural hearing loss in October 2011 and published helpful new information in the HBO Indications section of its website. The American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNSF) also includes hyperbaric oxygen in its clinical practice guidelines for sudden hearing loss.

How wonderful that hyperbaric oxygen may now be used to save people’s sight (central retinal artery occlusion) and hearing. But in both instances please note the need for speedy referral to a qualified HBOT practitioner. For sudden hearing loss, according to UHMS, “The best evidence supports the use of HBO2 within two weeks of symptom onset.” Also note the clinical evidence does not support the use of hyperbaric oxygen for chronic hearing loss or tinnitus.

Patient Resources

HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community support for sudden hearing loss.

Hear the World

A global initiative of Phonak, a manufacturer of hearing systems, Hear the World includes a nonprofit foundation focused on hearing loss prevention, screening, awareness, education, and support. Take the online hearing test.

American Speech-Language-Hearing Association (ASHA)

An association for audiologists, speech-language pathologists, and speech, language, and hearing scientists, ASHA provides Information for the Public on its website, including sections on screening and testing and hearing loss prevention. Read an illustrated explanation of How We Hear.

Clinical Resources

Start with the following resources to explore current research activities and the peer-reviewed medical literature on hyperbaric oxygen therapy for sudden hearing loss.

 Use the search buttons below to go directly to research on hyperbaric oxygen therapy.

American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS)

With 12,000 members, the AAO-HNS is the world's largest organization representing specialists who treat the ear, nose, throat, and related structures of the head and neck. The Academy includes hyperbaric oxygen therapy in its clinical practice guidelines for sudden hearing loss.

Read the AAO-HNS Clinical Practice Guideline: Sudden Hearing Loss [PDF].

American Speech-Language-Hearing Association (ASHA)

A professional, scientific, and credentialing association representing 135,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists, ASHA provides excellent information about hearing loss research, evidence-based practice, and links to other resources.

Read the ASHA article Evidence-Based Practice in Communication Disorders: An Introduction.

ClinicalTrials.gov
US National Institutes of Health

ClinicalTrials.gov keeps the official list of human clinical trials currently enrolling, in progress, and recently completed. One may reasonably question the size and legitimacy of any study not listed here.

Search ClinicalTrials.gov

Cochrane

An independent, international, nongovernmental organization, Cochrane is a powerful force in evidence-based medicine. One may consider a Cochrane article on any HBOT topic required reading.

Read the Cochrane Intervention Review: Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus  from the Cochrane Ear, Nose, and Throat Disorders Group, doi:10.1002/14651858.CD004739.pub3

Google Scholar

A specialized Google search engine, Google Scholar indexes scholarly articles, patents, and legal opinions and journals. Google Scholar may produce many search results, but entries provide easy access to full-text journal articles.

Search Google Scholar

HBOEvidence

HBOEvidence uses computerized tools to appraise the key randomized controlled trials (RCTs) in the hyperbaric medical literature. One may reasonably question the overall strength of HBOT evidence for any disease or condition not covered here.

Search HBOEvidence

Medscape

A service of WebMD, Medscape offers specialists, primary care physicians, and other health professionals robust and integrated medical information and educational tools. The website devotes a couple paragraphs to hyperbaric oxygen therapy under Medical Care for sudden hearing loss.

Read the Medscape article Sudden Hearing Loss Treatment and Management.

National Institute on Deafness and Other Communication Disorders (NIDCD)
US National Institutes of Health

The NIDCD is the government’s focal point for research into the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

Read the NIDCD article Sudden Deafness.

PubMed.gov
US National Library of Medicine, US National Institutes of Health

PubMed keeps the official list of scientific papers published in reputable peer-reviewed medical journals. One may reasonably question the importance and legitimacy of any study not listed here.

Search PubMed.gov

 

News About Sensorineural Hearing Loss and Hyperbaric Oxygen Therapy

New on HyperbaricLink: Sudden Hearing Loss

Sunday, 11/24

Today we have added sensorineural hearing loss to our Diseases and Conditions section. Nerve-related deafness is a sudden or rapidly progressive loss of hearing related to problems with the inner ear and the nerves that connect read more...

More news from O2.0 – the HyperbaricLink blog


Complete sensorineural hearing loss news archive from O2.0 — the HyperbaricLink blog

Further Reading

HyperbaricLink suggests The Heart Is a Lonely Hunter, by Carson McCullers (1940).

Related Terms

  • Auditory nerve
  • Auditory vestibular nerve
  • Chronic sudden sensorineural hearing loss
  • Cochlea
  • Cochlear nerve
  • Communication disorders
  • Deafness
  • Ear
  • Eighth cranial nerve
  • Endolymph
  • Facial nerve
  • Initial profound SNHL
  • Inner ear
  • ISSHL
  • ISSNHL
  • Perilymph
  • Profound hearing loss
  • Sudden deafness
  • Sudden hearing loss (SHL)
  • Sudden sensorineural hearing loss (SSNHL)
  • Tinnitus
  • Total hearing loss
  • Vestibular nerve
  • Vestibulocochlear nerve
Sources
National Institute on Deafness and Other Communication Disorders (NIDCD), US National Institutes of Health. Sudden Deafness. Retrieved  02 May 2015.
www.nidcd.nih.gov/health/hearing/pages/sudden.aspx
Bennett MH, Kertesz T, Perleth M, Yeung P. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus.
Cochrane Database of Systematic Reviews 2007, Updated 2012.
Retrieved 16 August 2015.
doi: 10.1002/14651858.CD004739.pub4
Page Data
Updated: 28 Jul 2015 01:35 PM
Created: 17 Jun 2013 02:35 PM
By: About the authors »