Rhee TM, et al. - Experts conducted a systematic review and meta-analysis to compare hyperbaric oxygen therapy (HBOT) + medical therapy (MT) with MT alone as a treatment for patients with sudden sensorineural hearing loss (SSNHL). A reasonable treatment option for SSNHL, particularly for those patients with severe to profound hearing loss at baseline and those who undergo HBOT as a salvage treatment with a prolonged duration is the addition of HBOT to standard MT. Experts suggested the application of optimal criteria for patient selection and a standardized regimen for HBOT in routine practice.

Methods

• Researchers systematically searched PubMed, Embase, and the Cochrane Database of Systematic Reviews up to February 2018.
• Study selection included the randomized clinical trials and nonrandomized studies comparing HBOT + MT with MT alone for SSNHL treatment.
• The eligible studies were screened, data were established, and quality and risk of bias was assessed independently by 2 investigators.
• They conducted a systematic review and meta-analysis using random-effects models.
• Complete hearing recovery was included in the primary outcome, and secondary outcomes were any hearing recovery and absolute hearing gain.

Results

• Authors included 3 randomized clinical trials and 16 nonrandomized studies comparing outcomes after HBOT + MT vs MT alone in 2,401 patients with SSNHL (mean age, 45.4 years; 55.3% female).
• In the HBOT + MT group, pooled odds ratios (ORs) for complete hearing recovery and any hearing recovery were significantly higher than in the MT alone group (complete hearing recovery OR, 1.61; 95% CI, 1.05-2.44 and any hearing recovery OR, 1.43; 95% CI, 1.20-1.67).
• In the HBOT + MT group, absolute hearing gain was also significantly greater than in the MT alone group.
• In groups with severe to profound hearing loss, the benefit of HBOT was greater at baseline, HBOT as a salvage treatment, and a total HBOT duration of at least 1,200 minutes.