Overview of Hyperbaric Treatment of Sensorineural Hearing Loss

Sudden sensorineural hearing loss is a condition where a person loses their hearing by at least 30 decibels across at least three different sound frequencies, lasting for at least three days. The actual cause of this loss can only be identified in about 10% to 15% of the cases – it mostly remains unknown. However, there are several potential reasons including blocked blood vessels, viral infections, damage in the inner ear membranes, immune system diseases, injuries, toxins, damage in the cochlear membrane (part of inner ear), nervous system diseases, stroke, and a type of tumor called schwannoma.

Patients typically notice symptoms when they wake up, describing a feeling of fullness or blockage in the ear. They might also experience tinnitus (regular ringing in the ears), dizziness, or a spinning sensation named vertigo. Around 4000 new cases of this condition appear in the United States each year. It’s difficult to know how many patients recover on their own, because many don’t seek medical help, but estimates range from 25% to 65%. For those participating in medical trials, those receiving no treatment had a recovery rate of 35% to 39% typically.

Hearing loss can seriously impact a person’s quality of life, adding considerable social and economic challenges. According to the World Health Organization (WHO), adult-onset hearing loss is the most common cause of disability worldwide and is the third leading cause of productivity loss due to disability. Hearing aids are suggested for those with moderate (41 decibels to 60 decibels) and severe (61 decibels and more) hearing loss.

Over 60 treatments have been suggested for sudden sensorineural hearing loss, but the majority aren’t very effective. The three most promising treatments include corticosteroids (medications that reduce inflammation), vasodilators (drugs that widen blood vessels) and hyperbaric oxygen therapy (a treatment that involves breathing pure oxygen in a special chamber). Among these options, only hyperbaric oxygen therapy has had enough successful trials to have a positive review by Cochrane, an organization that examines medical research.

Anatomy and Physiology of Hyperbaric Treatment of Sensorineural Hearing Loss

The cochlea, a part of the inner ear, plays a significant role in our hearing function. Being a high oxygen-demanding organ, its health is vital for proper hearing. When the cochlea doesn’t get enough oxygen, a condition known as cochlear hypoxia, it can lead to various problems. These include the hardening of tissues (ossification), development of fibrous tissue (fibrosis), loss of neurons (nerve cells), an increase in fluid in the inner ear (endolymphatic hydrops), and hearing loss.

Now, the blood supply directly reaching the organ of Corti, a structure in the cochlea essential for hearing, is quite low. So, oxygen must reach there through a process of diffusion from surrounding liquids called the perilymph and cortilymph. The labyrinthine artery, also known as the internal auditory artery, plays an important role in this. It is a thin artery that usually branches off from the anterior inferior cerebellar artery (85% of the time) or the basilar artery (15% of the time).

Just like a loyal companion, this artery travels with the vestibulocochlear nerve (the nerve responsible for hearing and balance) through a passageway called the internal acoustic meatus into the inner ear. However, if the labyrinthine artery gets blocked for some reason, it can cut off the oxygen supply to the cochlea and cause hearing loss. Animal studies have shown that blockage of this artery leads to progressive degenerative changes, fibrosis, new bone formation, and hearing loss.

So, ensuring the health of this artery is crucial to maintain good hearing as any problem that blocks this artery can lead to hearing loss.

Why do People Need Hyperbaric Treatment of Sensorineural Hearing Loss

Hyperbaric oxygen therapy, which involves breathing in pure oxygen in a special chamber, can help improve hearing in many people suffering from sudden hearing loss. The success of this treatment relies on a number of factors, such as whether the tiny artery in the ear is open and the ability to increase oxygen levels in the inner ear. Many detailed studies have shown that this therapy is more beneficial than a placebo.

For the best results, patients are usually treated within two weeks of first noticing their symptoms and given steroids alongside to boost the effect. The steroids are often given as an initial strong dose and then reduced over 2-3 weeks. This type of treatment is particularly considered for those with moderate to severe hearing loss, defined as a loss greater than 40 decibels.

The American Academy of Otolaryngology suggests considering hyperbaric oxygen therapy for any patient up to three months from when symptoms first appear. It advises against the routine use of antiviral drugs, clot-busting drugs, agents that dilate blood vessels, and antioxidants. Even if the initial steroid treatment doesn’t work, combined treatment of injecting steroids directly to ear and hyperbaric oxygen therapy can often still be beneficial up to ten weeks after symptoms start.

Patients should be examined by a ear specialist (otolaryngologist) and a hearing (audiology) expert. They will use a special test (an audiogram) to check the hearing and an MRI scan to rule out problems at the back of the inner ear. They may also check for autoimmune diseases and inflammation of the blood vessels, and an auditory brainstem response, which checks the electrical signals in the hearing nerves and brainstem.

Hearing tests should be done during and after the course of hyperbaric oxygen therapy and again six months after the treatment. Furthermore, patients should be informed about what they can expect from the condition, the benefits and risks of the treatment, and the limitations of existing studies on how effective the treatment is. They should be warned that full restoration of hearing might not be achievable and that hearing aids and other assistive technology might be beneficial. Providing support and taking other measurement for coping can also be helpful.

When a Person Should Avoid Hyperbaric Treatment of Sensorineural Hearing Loss

There are a few reasons why a person might not be able to receive hyperbaric oxygen therapy, a treatment where you breathe in pure oxygen in a pressurized room or tube. These reasons may include:

Having fear of enclosed spaces, having severe heart failure, suffering from severe lung problems, having an untreated collapsed lung, or being currently treated with certain medications like doxorubicin or bleomycin.

Similarly, some conditions might prevent a person from being able to take systemic corticosteroids, a class of drugs that can be used to reduce inflammation. These conditions may include certain mental illnesses, diabetes, stomach ulcers, breastfeeding, and liver disease.

For people with these conditions, another type of medicine called intra-tympanic steroids (which are given by injecting the steroid into the ear) might be a better choice.

Equipment used for Hyperbaric Treatment of Sensorineural Hearing Loss

Patients can receive treatment in one of two types of special rooms called hyperbaric chambers. These chambers can either be designed for one person at a time, known as a monoplace chamber, or they can accommodate more than one person, referred to as a multiplace chamber.

Who is needed to perform Hyperbaric Treatment of Sensorineural Hearing Loss?

When using a multiplace chamber, which is a kind of special treatment room that can hold more than one person, two important roles are needed. The inside tender is the person who stays inside the chamber with the patient during the procedure, providing direct care. The outside chamber operator is responsible for controlling the equipment from the outside. Both of these people work together to ensure the chamber functions effectively and the patient’s treatment goes well.

Preparing for Hyperbaric Treatment of Sensorineural Hearing Loss

Before starting any treatment, it’s important for doctors to check patients for certain conditions that could be treated or changed, like a fever or low blood sugar. This helps avoid any complications during the treatment process.

How is Hyperbaric Treatment of Sensorineural Hearing Loss performed

Hyperbaric oxygen therapy, a treatment which involves breathing pure oxygen in a pressurized room or tube, is recommended to be carried out with a pressure level of 2.0 to 2.5 ATA (Atmospheres Absolute). The procedure typically lasts for 90 minutes and is conducted once per day. The entire therapy course usually involves 10 to 20 individual sessions, depending on how well you respond to the treatment.

It’s worth noting that if there’s no noticeable improvement (10 decibels or less) after the first ten sessions, the chances of the treatment being helpful might be lower. So, it’s important to track your progress closely and discuss it with your doctor.

Possible Complications of Hyperbaric Treatment of Sensorineural Hearing Loss

Damage to the middle ear, known as barotrauma, is the most frequent side effect of hyperbaric oxygen therapy, a type of treatment where a patient breathes in pure oxygen in a specially designed room or tube. Though it happens in about 13% of cases, luckily, most people recover fully with no lasting troubles. There are ways to reduce the likelihood of this happening, like using a slower rate of pressure change during therapy, teaching patients the right way to unblock their ears, and using decongestant medicines.

To assess the level of damage to the ear and determine the best way to treat it, doctors often use a grading scale, and the one devised by O’Neill has proven to be more useful and reliable than the scale created by Teed.

What Else Should I Know About Hyperbaric Treatment of Sensorineural Hearing Loss?

Hearing loss can greatly impact the quality of life for individuals and their families, and could possibly hinder their professional life. Hearing aids, which range from $1500 to $3000 per pair, need to be replaced every 3 to 5 years. Unfortunately, using these aids don’t completely restore normal hearing.

Another option for treatment of hearing loss is an oxygen therapy known as hyperbaric oxygen therapy. This therapy involves breathing in pure oxygen in a pressurized environment or room, which can cost between $2000 and $5000 for a set of 10 treatments in an outpatient facility. Outpatient means you don’t need to stay overnight in a hospital.

This therapy has been seen to help significantly improve hearing for people who have recently experienced a sudden loss of hearing due to damage in the inner ear – a condition referred to as sudden sensorineural hearing loss. In fact, on average, every five people treated with the therapy, one would show considerable improvement.

For people with moderate hearing loss, these treatments could improve their hearing by approximately 19.3 decibels, which is a unit used to measure the intensity of sound. For people with severe hearing loss, the improvement could be even greater, with an average of 37.7 decibels. This substantial improvement could mean that some people might no longer need to use hearing aids or learn to lip read, and might only have slight, to no hearing impairments after the treatment.

Frequently asked questions

1. What is the success rate of hyperbaric oxygen therapy for treating sensorineural hearing loss? 2. How soon should I start the treatment after experiencing symptoms of sudden hearing loss? 3. What are the potential risks or side effects of hyperbaric oxygen therapy? 4. How many sessions of hyperbaric oxygen therapy will I need, and how often? 5. What other treatment options are available for sensorineural hearing loss, and how does hyperbaric oxygen therapy compare to them in terms of effectiveness and cost?

Hyperbaric treatment of sensorineural hearing loss can potentially improve hearing by increasing the oxygen supply to the cochlea. This treatment involves exposing the body to high levels of oxygen in a pressurized chamber, which can help to restore the health of the labyrinthine artery and prevent blockages. By improving blood flow and oxygenation to the cochlea, hyperbaric treatment may alleviate the degenerative changes, fibrosis, and new bone formation that can lead to hearing loss.

Based on the given text, there is no specific mention of hyperbaric treatment being used for sensorineural hearing loss. Therefore, it cannot be concluded that someone would need hyperbaric treatment for this condition.

You should not get Hyperbaric Treatment of Sensorineural Hearing Loss if you have a fear of enclosed spaces, severe heart failure, severe lung problems, an untreated collapsed lung, or if you are currently being treated with certain medications like doxorubicin or bleomycin. Additionally, if you have certain mental illnesses, diabetes, stomach ulcers, breastfeeding, or liver disease, you may not be able to take systemic corticosteroids, which are used in this treatment.

Hyperbaric Treatment of Sensorineural Hearing Loss has been shown to significantly improve hearing in people who have recently experienced a sudden loss of hearing due to damage in the inner ear. On average, every five people treated with this therapy, one would show considerable improvement. For people with moderate hearing loss, these treatments could improve their hearing by approximately 19.3 decibels, and for people with severe hearing loss, the improvement could be even greater, with an average of 37.7 decibels.

To prepare for Hyperbaric Treatment of Sensorineural Hearing Loss, patients should be examined by an ear specialist and a hearing expert. They may undergo tests such as an audiogram and an MRI scan to assess their hearing and rule out any underlying issues. Patients should also be informed about the benefits and risks of the treatment, as well as the limitations of existing studies on its effectiveness.

The most frequent complication of hyperbaric treatment of sensorineural hearing loss is damage to the middle ear, known as barotrauma. This occurs in about 13% of cases but most people recover fully with no lasting troubles. To reduce the likelihood of barotrauma, slower rates of pressure change during therapy, teaching patients the right way to unblock their ears, and using decongestant medicines can be used. Doctors often use a grading scale, such as the one devised by O'Neill, to assess the level of damage to the ear and determine the best way to treat it.

The text does not provide specific symptoms that require Hyperbaric Treatment of Sensorineural Hearing Loss. However, it mentions that this type of treatment is particularly considered for those with moderate to severe hearing loss, defined as a loss greater than 40 decibels. Additionally, the American Academy of Otolaryngology suggests considering hyperbaric oxygen therapy for any patient up to three months from when symptoms first appear.

There is no specific information provided in the given text about the safety of hyperbaric treatment of sensorineural hearing loss in pregnancy. It is recommended to consult with a healthcare professional or specialist in the field for personalized advice and guidance regarding this treatment during pregnancy.

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