National Ear Care Day | Hyperbaric oxygen therapy for sudden deafness

Sudden deafness, or "sudden deafness" for short, is a common acute disease in the Department of Otolaryngology, characterized by rapid onset and rapid progression. In addition to unilateral or bilateral hearing loss, patients with sudden deafness may also experience symptoms such as dizziness, tinnitus, nausea, and vomiting. Some patients may also experience mental and psychological problems, such as anxiety and sleep disorders, which can seriously affect the quality of life of patients.

Causes and treatment of sudden deafness

Since the cause of sudden deafness has not been fully clarified, there is no unified treatment plan. The treatment method is mainly based on hormone therapy, supplemented by drugs that improve microcirculation and nourish nerves. However, some patients (such as diabetic patients) cannot tolerate systemic use of hormones. In addition to drug therapy, hyperbaric oxygen therapy as a non-drug treatment method has also been used to treat sudden deafness and has achieved certain results.

Regardless of the cause of sudden deafness, the core problem is insufficient blood supply to the inner ear, which leads to a decrease in the oxygen content in the perilymph, which in turn damages the hair cells and ultimately leads to hearing loss. Hyperbaric oxygen therapy can increase the partial pressure of oxygen in the local blood and increase the diffusion rate of blood oxygen, thereby increasing the oxygen content in the cells and improving the hypoxic state of the cochlear tissue. Hyperbaric oxygen therapy can also promote the formation of new blood vessels in the damaged area and the establishment of collateral circulation, reduce the hypercoagulable state of blood after viral infection, reduce platelet aggregation and blood viscosity, enhance the deformability of red blood cells and the function of phagocytes, activate the free radical scavenging mechanism in the body to reduce free radical damage to the cochlea, and inhibit inflammatory response.

Hyperbaric oxygen therapy for sudden deafness

For patients with sudden deafness, hyperbaric oxygen therapy should be started early rather than late, and early hyperbaric oxygen therapy can achieve better results. According to the guidelines for the treatment of sudden deafness issued by the United States in 2019, it is recommended to combine hyperbaric oxygen therapy with steroid hormone therapy as the initial treatment plan within 2 weeks after the onset of the disease. Generally speaking, the younger the age of onset, the earlier the treatment starts, and the patients with low-frequency hearing loss curve and milder hearing damage have more obvious treatment effects. In addition to improving hearing, hyperbaric oxygen-assisted therapy can effectively relieve accompanying symptoms such as tinnitus, stuffy ears, and dizziness in patients with sudden deafness.

Hyperbaric oxygen therapy can not only be used as an initial treatment method, but is also recommended as a rescue treatment measure for sudden deafness. The American Guidelines for Sudden Deafness (2019) recommend that hyperbaric oxygen therapy can be used as a rescue treatment within 1 month after onset. In the European Consensus on Hyperbaric Oxygen Therapy published in 2017, it is recommended that hyperbaric oxygen therapy be performed within 6 months of the onset of sudden deafness.

(Author: Zhang Yi, Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University)