Benefits of Hyperbaric Oxygen Therapy in the Management of Sensorineural Hearing Loss (SNHL) I Rajgurunagar, Maharashtra, INDIA
Learn about the benefits of hyperbaric oxygen therapy (HBOT) for SNHL in Rajgurunagar, Maharashtra, INDIA
HBOT: Transforming the Echoes of Silence in Rajgurunagar, India
Sensorineural Hearing Loss (SNHL) is a prevalent form of hearing impairment, resulting from damage to the inner ear’s sensory hair cells or the auditory nerve pathways. It’s crucial to explore its definition, characteristics, underlying causes, risk factors, and its profound impact on the quality of life for individuals
Definition and Characteristics of SNHL
SNHL, also known as sensorineural deafness, arises from inner ear damage, affecting the sensory hair cells or auditory nerve pathways. Unlike conductive hearing loss, which involves the middle or outer ear, SNHL impacts the intricate structures responsible for translating sound vibrations into brain-interpreted electrical signals.
SNHL is marked by a reduced ability to perceive sounds, especially in higher frequencies, with the following traits:
Gradual Onset
Often unnoticed until it significantly impacts daily life, SNHL may develop slowly over time.
Reduced Clarity
Sounds become less distinct, making it challenging to understand speech or environmental noises.
Tinnitus
Many SNHL individuals experience ringing, buzzing, or phantom sounds in the ear.
Noisy Environments
Background noise interferes with speech comprehension, complicating conversations in crowded or noisy settings.
Causes and Risk Factors
- Noise Exposure: Prolonged exposure to loud noises, such as machinery or music concerts, damages inner ear hair cells.
- Aging (Presbycusis): Age-related hearing loss affects cochlear hair cells and typically occurs with age.
- Ototoxic Medications: Certain drugs, like antibiotics and chemotherapy agents, can harm inner ear cells, causing SNHL.
- Infections: Viral or bacterial infections, like mumps or meningitis, can lead to SNHL.
- Genetic Factors: Genetic mutations may increase susceptibility to SNHL, affecting inner ear development or function.
- Trauma: Head injuries or pressure changes, like those from scuba diving, can damage the inner ear.
- Tumors: Non-cancerous growths, such as vestibular schwannomas, can press on the auditory nerve, leading to SNHL.
- Vascular Issues: Circulation problems affecting the inner ear’s blood supply can contribute to SNHL.
The Potential of HBOT in Treating SNHL
Sensorineural Hearing Loss (SNHL) is a challenging auditory condition with significant repercussions on individuals’ lives. This section explores the potential of Hyperbaric Oxygen Therapy (HBOT) as a treatment for SNHL. To understand this potential, we will delve into the theoretical basis for using HBOT in SNHL treatment, review scientific studies and clinical trials, and explore the underlying mechanisms by which HBOT may facilitate SNHL recovery.
Theoretical Basis for Using HBOT in SNHL Treatment
Hyperbaric Oxygen Therapy (HBOT) involves breathing pure oxygen in a pressurized chamber, which elevates the oxygen levels in the blood and supports healing. HBOT has been explored as a treatment for various medical conditions, including SNHL. The theoretical rationale for using HBOT in SNHL treatment lies in its potential to enhance the oxygen supply to damaged inner ear tissues, thereby promoting healing, and reducing inflammation.
Mechanisms Through Which HBOT Aids in SNHL Recovery
While the exact mechanisms underlying how Hyperbaric Oxygen Therapy (HBOT) improves Sensorineural Hearing Loss (SNHL) require further exploration, several potential pathways have been proposed based on existing research:
Improved Oxygenation
HBOT enhances tissue oxygenation, supplying the necessary substrate for cellular respiration and energy production.
Enhanced oxygenation may support the repair and regeneration of damaged inner ear cells.
Anti-Inflammatory Effects
HBOT exhibits anti-inflammatory properties, potentially reducing inflammation within the auditory structures.
This anti-inflammatory action can protect against further damage and contribute to the healing process.
Enhanced Neuroprotection
By increasing oxygen delivery to auditory nerve pathways and relevant brain regions, HBOT may offer neuroprotection.
This neuroprotection may help safeguard critical components from ongoing damage, potentially preserving or restoring auditory function.
Resolution of Ischemia and Edema
SNHL often involves ischemia (reduced blood flow) and edema (swelling) in the inner ear.
HBOT may aid in resolving these conditions by promoting blood vessel dilation and reducing fluid accumulation, thus alleviating pressure on the auditory structures.
HBOT, or hyperbaric oxygen therapy, holds promise as a treatment for SNHL. Here are some ways in which HBOT may contribute to the treatment of SNHL, based on available research studies:
HBOT may lower cytokines associated with inflammation in peripheral blood, which might enhance hearing in people with sudden sensorineural hearing loss (SSNHL).
Increased oxygen delivery to injured inner ear tissues with HBOT may aid in the promotion of healing and the reduction of inflammation.
Oxygen transport, hemodynamics, and the cellular immune system are all significantly impacted by HBOT. It can lessen tissue hypoxia, reduce edema, and alter the inner ear’s microcirculation.
HBOT can boost perilymph oxygenation when used once daily in a multi-station hyperbaric chamber at a constant pressure of 2.2 atmospheres.
The effectiveness of HBOT in the treatment of SSNHL is time-dependent and declines with increasing administration delay. Therefore, it is imperative to start HBOT treatment as soon as symptoms appear.
For SSNHL, combining HBOT with steroid treatment has demonstrated appreciable additional advantages. The combination use of HBOT and medicinal therapy is encouraged by the European Committee for Hyperbaric Medicine (EHMS), especially for individuals with acute idiopathic SSNHL who seek treatment within two weeks of the beginning of the illness.
Research and Clinical Trials Supporting Link for HBOT in SNHL
One study conducted by Cavaliere et al. in 2022 examined the combination of HBOT and oral steroids for SSNHL treatment. Their findings indicated that HBOT, when administered within the first week of SSNHL onset, produced enhanced auditory outcomes. The study highlighted the importance of timing in treatment efficacy. Another research study by Muzzi et al. (2010) explored HBOT as a rescue therapy for SSNHL patients who didn’t respond to conventional treatments. It revealed that HBOT had a solid scientific basis and could increase pure tone hearing thresholds, especially in cases of acute SSNHL resistant to medical therapy.
Rhee et al. (2018) conducted a comprehensive meta-analysis to assess the effectiveness of HBOT in SSNHL treatment. Their study involved 19 trials with 2401 SSNHL patients and found that HBOT, particularly in cases of significant hearing loss, demonstrated superior complete and partial hearing recovery rates. Focusing on divers with SSNHL, Van Der Wal et al. (2016) evaluated the utility of HBOT. The results showcased HBOT’s potential to improve hearing in such cases, shedding light on its application as a treatment option.
Horn et al. (2005) examined HBOT as a follow-up treatment after the failure of steroid and antiviral therapy in SSNHL patients. While some patients benefited from HBOT, others required ear tube insertion due to complications. Yıldırım et al. (2015) conducted a retrospective analysis on 59 SSNHL patients to determine the effect of the timing of HBOT initiation. Their findings emphasized that starting HBOT within the first 14 days of SSNHL onset significantly improved prognosis.Pezzoli et al. (2015) investigated HBOT as a salvage treatment for SSNHL patients who didn’t improve with initial steroid therapy. Their study suggested that HBOT could significantly enhance hearing, particularly when initiated within four weeks of symptom onset.
Liu et al. (2011) reviewed 465 cases of SSNHL and recommended HBOT as an adjunct therapy, especially for individuals with severe hearing loss. They found that patients with substantial initial hearing loss could benefit from HBOT.Cvorovic et al. (2013) conducted a prospective trial that compared the effectiveness of HBOT and intratympanic steroid injection as salvage therapies for SSNHL after initial steroid therapy. It indicated that both HBOT and intratympanic steroid therapy improved hearing, with HBOT performing better in certain subgroups.In a retrospective analysis of over 2000 patients, Choi et al. (2023) explored the therapeutic effects of HBOT, particularly in diabetic individuals with severe to profound SSNHL. They suggested that HBOT, in combination with steroids, could hold potential benefits for this specific patient group.
References
Cavaliere, Matteo, Pietro De Luca, Alfonso Scarpa, Adriano Maciej Strzalkowski, Massimo Ralli, Matteo Calvanese, Luisa Savignano, Pasquale Viola, Claudia Cassandro, Giuseppe Chiarella, and et al. 2022. “Combination of Hyperbaric Oxygen Therapy and Oral Steroids for the Treatment of Sudden Sensorineural Hearing Loss: Early or Late?” Medicina 58, no. 10: 1421. https://doi.org/10.3390/medicina58101421
Muzzi, E., Zennaro, B., Visentin, R., Soldano, F., & Sacilotto, C. (2010). Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: Review of rationale and preliminary report. The Journal of Laryngology & Otology, 124(2), E2. doi:10.1017/S0022215109992052
Rhee T, Hwang D, Lee J, Park J, Lee JM. Addition of Hyperbaric Oxygen Therapy vs Medical Therapy Alone for Idiopathic Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1153–1161. doi:10.1001/jamaoto.2018.2133
Van Der Wal, A., Van Ooij, P., & De Ru, J. (2016). Hyperbaric oxygen therapy for sudden sensorineural hearing loss in divers. The Journal of Laryngology & Otology, 130(11), 1039-1047. doi:10.1017/S0022215116009075
Horn, Corinne E; Himel, Harvey N; Selesnick, Samuel H. Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss: A Prospective Trial of Patients Failing Steroid and Antiviral Treatment. Otology & Neurotology 26(5): p 882-889, September 2005. | DOI: 10.1097/01.mao.0000185053.15136.26
Yıldırım, E., Murat Özcan, K., Palalı, M. et al. Prognostic effect of hyperbaric oxygen therapy starting time for sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 272, 23–28 (2015). https://doi.org/10.1007/s00405-013-2829-x
Pezzoli, M., Magnano, M., Maffi, L. et al. Hyperbaric oxygen therapy as salvage treatment for sudden sensorineural hearing loss: a prospective controlled study. Eur Arch Otorhinolaryngol 272, 1659–1666 (2015). https://doi.org/10.1007/s00405-014-2948-z
Liu, S‐C., B‐H. Kang, J‐C. Lee, Y‐S. Lin, K‐L. Huang, D‐W. Liu, W‐F. Su et al. “Comparison of therapeutic results in sudden sensorineural hearing loss with/without additional hyperbaric oxygen therapy: a retrospective review of 465 audiologically controlled cases.” Clinical Otolaryngology 36, no. 2 (2011): 121-128.
Cvorovic, Ljiljana*†; Jovanovic, Milan B.*†; Milutinovic, Zoran*†; Arsovic, Nenad*‡; Djeric, Dragoslava*‡. Randomized Prospective Trial of Hyperbaric Oxygen Therapy and Intratympanic Steroid Injection as Salvage Treatment of Sudden Sensorineural Hearing Loss. Otology & Neurotology 34(6): p 1021-1026, August 2013. | DOI: 10.1097/MAO.0b013e318297638a
Yeso Choi, Sung Jun Han, Sung Kyun Kim et al. The therapeutic effect of hyperbaric oxygen therapy in patients with severe to profound idiopathic sudden sensorineural hearing loss, 29 August 2023, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-3278721/v1]
