Frequency

The annual number of new cases is estimated at 10-20 cases per 100,000 inhabitants. A more recent German study increases these figures to 160 new cases per 100,000 inhabitants.

Characteristics of Sudden Deafness

Clogged ear sensation, hearing loss, tinnitus. The hearing loss is confirmed with the audiogram by the ENT doctor.

Spontaneous evolution

• 1993: Up to 1/3 of affected patients recover spontaneously without any treatment. In others, permanent deafness often accompanied by tinnitus sets in.
• 2023: Spontaneous recovery from sudden deafness is close to 60%. The problem is that if spontaneous recovery is expected and it does not occur, it may be too late for treatment.

HBOT clinical studies

• 2007: If treatment is not initiated quickly, whether cortisone is given or not is the same thing.
• 2010: Most of the treatments used to treat sudden deafness are not very effective.
• 2005: Secondary HBOT after failure of systemic corticosteroids therapy and antiviral therapy may be associated with hearing gains.
• 2006: HBOT is effective in the failure of conventional treatments. The results are better when the HBOT delay is short.
• 2007: The combination of HBOT and cortisone is the most effective.
• 2007: The recovery rate was significantly higher in the HBOT + steroids group than in the steroid alone group.
• 2009: The effectiveness of drugs improving circulation is not proven.
• 2010: HBOT has strong scientific justification and improves hearing thresholds in cases that do not respond to medical treatment.
• 2010: The effectiveness of secondary HBOT in the sub acute or chronic phase remains to be proven although it seems that severe cases could benefit from it.
• 2011: Our clinical experience suggests that the combination of steroids and HBOT has effects beneficial in the early phase.
• 2011: Patients with sudden hearing loss receiving combination therapy of oral steroids + HBOT have a greater likelihood of recovery than patients receiving oral steroids, HBOT or intra-tympanic steroids alone.
• 2011: Patients who started HBOT treatment within 10 days are more likely to recover than those who started treatment later.
• 2011: We systematically recommend HBOT combined with drug treatment for patients with severe sudden hearing loss.
• 2012: For people with sudden acute deafness, the application of HBOT significantly improved hearing, but the clinical significance remains unclear. There is no evidence of a beneficial effect of HBOT on chronic old hearing loss or tinnitus and we do not recommend its use in such cases.
• 2012: Experts from the American ENT Society recommend corticosteroids as initial treatment and HBOT within 3 months of diagnosis.
• 2013: The effectiveness of cortisone in sudden deafness is contradictory.
• 2013: The combination of intra-tympanic steroids and HBOT may lead to greater improvement in speech audiometry, especially in the low frequencies.
• 2013: Both HBOT and intra-tympanic steroid injection are effective in patients who have not responded to conventional steroids.
• 2015: HBOT started within the first 14 days after sudden deafness has a positive effect on the prognosis of the disease. This is no longer the case if HBOT is started later.
• 2015: HBOT may lead to improvement in patients who have failed primary corticosteroid therapy and are within 4 weeks of onset of deafness.
• 2018: Adding HBOT to standard treatments for sudden hearing loss is a reasonable treatment option, especially for patients with severe or profound hearing loss.
• 2021: Adding HBOT to steroids within 7 days for 10-25 treatment sessions has shown the best results.
• 2022: HBOT is effective if applied quickly with steroids.
• 2022: Addition of HBOT to systemic steroids resulted in no significant improvement in hearing, despite a slight trend towards a higher rate of improvement in the combined group
• 2022: Patients on steroids starting HBOT therapy within 12 days showed 6.484 times greater improvements than those starting HBOT later.
• 2022: In this systematic review and meta-analysis, HBOT as part of a combination treatment was significantly associated with improved hearing outcomes in patients with sudden hearing loss compared to control treatments.
• 2023: HBOT alone, without cortisone, cures more than 70% of patients when performed within 72 hours. The average hearing threshold improves by 31.4 dB
• 2023: The combination of HBOT and steroids is useful for both early and late treatment.

Practical use of HBOT

HBOT should be started as soon as sudden hearing loss occurs. 15 consecutive sessions are prescribed until the first auditory evaluation. HBOT still appears to be effective in cases where other forms of treatment have failed. However, HBOT should be started as soon as failure of the first treatment has been established. Many patients come to us too late or have to give up treatment for economic reasons.